| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $42K | — | $42K | 5.06% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVE, STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $368 | $368 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 PROVIDER | Plan Administrator Service code 14 | PO BOX 7639 PHILADELPHIA, PA 19176 | $14K |
| COMPSYCH EIN 35-3739783 TPA | Plan Administrator Service code 14 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 60611 | $0 |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,033 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,033 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,033 | $837K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,033 | $837K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,033 | $837K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,033 | $837K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,033 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.