| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5 | $5 | 0.00% |
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMPANY EASTERN | P.O. BOX 4125 CHURCH STREET STATION NEW YORK, NY 102614125 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| TEMPO HOLDINGS COMPANY LLC3 | 4 OVERLOOK POINT LINCOLNSHIRE, IL 60069 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMPANY EASTERN | P.O. BOX 4125 CHURCH STREET STATION NEW YORK, NY 102614125 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| TEMPO HOLDINGS COMPANY LLC3 | 4 OVERLOOK POINT LINCOLNSHIRE, IL 60069 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMPANY EASTERN | P.O. BOX 4125 CHURCH STREET STATION NEW YORK, NY 102614125 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| TEMPO HOLDINGS COMPANY LLC3 | 4 OVERLOOK POINT LINCOLNSHIRE, IL 60069 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| THE SEGAL COMPANY3 Filed as: SEGAL EASTERN STATES | 120 FRONT STREET SUITE 430 WORCESTER, MA 01608 | METROPOLITAN GENERAL INSURANCE COMPANY | $2K | — | $2K | 28.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTHCARE EIN 06-1252419 NONE | Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Float revenue; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $1.3M |
| TOKIO MARINE EIN 35-1817054 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $1.2M |
| SIBSON CONSULTING EIN 13-1835864 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $46K |
| ALIGHT SOLUTIONS LLC EIN 36-2235791 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $44K |
| HARTFORD FIRE INSURANCE EIN 06-0383750 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $19K |
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 | 760 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 767 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TOKIO MARINE HCC - A&H GROUP | 714 | $1.2M |
| Dental(10 contracts, 10 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,943 | $842K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 107 | $14K |
| Other(6 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 835 | $235K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,943 | — |
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.