| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 0.62% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $78 | $78 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 0.44% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | — | $2K | $2K | 20.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 3280 PEACHTREE STREET NE ATLANTA, GA 30305 | FEDERAL INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| NANCY E ODOM3 Filed as: NANCY E. ODOM | 5921 STONE MEADOW DRIVE PLANO, TX 750934617 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 41.69% |
| DAVID M GUSTAFSON3 Filed as: DAVID M. GUSTAFSON | 316 WEST LOOKOUT DRIVE RICHARDSON, TX 75080 | CONTINENTAL AMERICAN INSURANCE COMPANY | $891 | — | $891 | 8.92% |
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 | 437 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 440 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 963 | $376K |
| Vision | VISION SERVICE PLAN | 382 | $97K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 963 | $818K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 712 | $442K |
| Other(6 contracts, 6 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 899 | $490K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 963 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.