| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | PO BOX 5682 CAROL STREAM, IL 60197 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $34K | — | $34K | 2.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | — | $22K | 1.26% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | PO BOX 5682 CAROL STREAM, IL 60197 | MINNESOTA LIFE INSURANCE COMPANY | $46K | — | $46K | 4.21% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | MINNESOTA LIFE INSURANCE COMPANY | $9K | $4K | $13K | 1.15% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | PO BOX 5682 CAROL STREAM, IL 60197 | MINNESOTA LIFE INSURANCE COMPANY | $32K | — | $32K | 4.18% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | MINNESOTA LIFE INSURANCE COMPANY | $6K | $3K | $9K | 1.18% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | PO BOX 5682 CAROL STREAM, IL 60197 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 6.71% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 3.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO OF NEW YORK | $156 | — | $156 | 3.19% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | PO BOX 5682 CAROL STREAM, IL 60197 | CIGNA LIFE INSURANCE CO OF NEW YORK | $25 | — | $25 | 0.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 ADMINISTRATION | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other services; Contract Administrator Service code 12 | — | $3.3M |
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 | 5,490 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 184 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 74 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,748 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 9,889 | $2.5M |
| Vision | VISION SERVICE PLAN | 3,289 | $673K |
| Life insurance(2 contracts) | MINNESOTA LIFE INSURANCE COMPANY | 5,717 | $1.9M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 481 | $158K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,163 | $1.7M |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 5,081 | $300K |
| Other(2 contracts, 2 carriers) | ARAG INSURANCE COMPANY | 402 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,889 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.