| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC5 Filed as: MARSH USA, INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 100362774 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $34K | $34K | 2.58% |
| FREDERICK W. HOWARTH III3 Filed as: FREDERICK HOWARTH III | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 1.13% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH BENEFITS | ADMINISTRATION LLC PO BOX 310502 DES MOINES, IA 52242 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 0.70% |
| MERCER HEALTH AND BENEFITS, LLC5 Filed as: MERCER | PO BOX 310072 DES MOINES, IA 50331 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.08% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN | PO BOX 310502 DES MOINES, IA 503310502 | UNITEDHEALTHCARE INSURANCE COMPANY | $12K | — | $12K | 5.00% |
| FREDERICK W. HOWARTH III3 Filed as: FREDERICK W HOWARTH III | DBA TBG WEST INSURANCE SERVICE 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | FIRST UNUM LIFE INSURANCE COMPANY | $62 | $1K | $1K | 1.21% |
No Schedule C service providers reported on this filing.
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 | 7,596 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 166 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,762 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRIPLE S SALUD, INC. | 7 | $30K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 10,954 | $336K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 3,112 | $240K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,977 | $1.3M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,977 | $1.3M |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,977 | $1.4M |
| Prescription drug | TRIPLE S SALUD, INC. | 7 | $30K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 10,954 | $306K |
| Other(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 10,954 | $463K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,954 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.