| 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 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 12.85% |
| BENEFITMALL5 Filed as: BENEFITMALL INC. | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $649 | $649 | 2.38% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 16.98% |
| BENEFITMALL5 Filed as: BENEFITMALL INC. | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $453 | $453 | 2.17% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $745 | — | $745 | 7.91% |
| BENEFITMALL5 Filed as: BENEFITMALL INC. | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $149 | $149 | 1.58% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $682 | — | $682 | 9.54% |
| BENEFITMALL5 Filed as: BENEFITMALL INC. | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $130 | $130 | 1.82% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $52 | — | $52 | 3.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $0 | $0 | — |
| CENTERSTONE INSURANCE AND FINANCIAL Filed as: CENTERSTONE INSURANCE (NJ) | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $0 | $0 | — |
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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 105 | $0 |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 105 | $0 |
| Vision | VISION SERVICE PLAN | 102 | $1K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $17K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $27K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $21K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.