| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.04% |
| MARSH & MCLENNAN AGENCY LLC3 | LOCKBOX 740659 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN INC | — | $239 | $239 | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | — | $1 | $1 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 2405 GRAND BOULEVARD SUITE 900 KANSAS CITY, MO 64108 | ACE AMERICAN INSURANCE COMPANY | $5K | — | $5K | 20.00% |
| CHRISTA G AUFDEMBERG INC4 | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 17.59% |
| MARSH & MCLENNAN AGENCY LLC4 Filed as: BARNEY & BARNEY | A MARSH MCLENNAN AGENCY LLC CO P.O. BOX 85638 SAN DIEGO, CA 92186 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $400 | — | $400 | 6.05% |
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 | 4,769 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 47 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,816 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 615 | $5.3M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,682 | $2.3M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,682 | $2.3M |
| Prescription drug(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 615 | $5.3M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,682 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,682 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.