| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | 3333 PIEDMONT ROAD NE, SUITE 1400 ATLANTA, GA 30305 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $44K | — | $44K | 2.82% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 0.61% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | 3333 PIEDMONT ROAD NE, SUITE 1400 ATLANTA, GA 30305 | MINNESOTA LIFE INSURANCE COMPANY | $59K | — | $59K | 5.00% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | 3333 PIEDMONT ROAD NE, SUITE 1400 ATLANTA, GA 30305 | MINNESOTA LIFE INSURANCE COMPANY | $42K | — | $42K | 5.00% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | PO BOX 5682 CAROL STREAM, IL 60197 | CIGNA LIFE INSURANCE CO OF NEW YORK | $129 | — | $129 | 2.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO OF NEW YORK | $12 | — | $12 | 0.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 ADMINISTRATION | Other services; Float revenue; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.4M |
| AMERIBEN/IEC GROUP EIN 82-0497661 TPA | Claims processing Service code 12 | — | $868K |
| AETNA BEHAVIORAL HEALTH LLC PLAN ADMINISTRATOR | Claims processing Service code 12 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $143K |
| HEALTH & HUMAN RESOURCE CENTER INC PLAN ADMINISTRATOR | Claims processing Service code 12 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $6K |
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 | 5,565 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 84 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 85 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,734 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 10,256 | $2.7M |
| Vision | VISION SERVICE PLAN | 3,581 | $749K |
| Life insurance(2 contracts) | MINNESOTA LIFE INSURANCE COMPANY | 5,758 | $2.0M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,243 | $1.6M |
| Other(2 contracts, 2 carriers) | ARAG INSURANCE COMPANY | 492 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,256 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.