| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 99 HIGH STREET BOSTON, MA 02110 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $20K | $5K | $25K | 0.89% |
| KELLER-STONEBRAKER INS INC3 Filed as: KELLER STONEBROAKER INSURANCE INC | 1120-C PROFESSIONAL COURT HAGERSTOWN, MD 21740 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $24K | — | $24K | 0.85% |
| KELLER-STONEBRAKER INS INC3 Filed as: KELLER STONEBRAKER INS, INC | 1120-C PROFESSIONAL COURT HAGERSTOWN, MD 21740 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $2K | — | $2K | 1.73% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | WASHINGTON SQUARE 1050 CONNECTICUT AVE WASHINGTON, DC 20036 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $2K | — | $2K | 1.41% |
| KELLER-STONEBRAKER INS INC3 Filed as: KELLER-STONEBRAKER INSURANCE I | 1120 C PROFESSIONAL COURT HAGERSTOWN, MD 21740 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 9.85% |
| KELLER-STONEBRAKER INS INC3 Filed as: KELLER STONEBRAKER - FREDERICK MD | 1120 C PROFESSIONAL COURT HAGERSTOWN, MD 21740 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 6.75% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $786 | — | $786 | 3.90% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY BENEFIT STRATEGIES | 1 KELLY WAY SPARKS, MD 21152 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $651 | $651 | 3.23% |
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 | 136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 405 | $2.8M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 412 | $116K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 406 | $20K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 136 | $62K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 136 | $62K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 136 | $62K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 405 | $2.8M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 406 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 412 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.