| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | P.O. BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $37K | — | $37K | 1.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON, PA | LOCKBOX #9102 P.O. BOX 8500 PHILADELPHIA, PA 191780001 | KAISER FOUNDATION HEALTH PLAN INC. | $17K | — | $17K | 0.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | P.O. BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $16K | $16K | 0.73% |
| PETER J WORTH3 Filed as: PETER WORTH | 99 PARK AVE. STE 2500 NEW YORK, NY 100161601 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 0.25% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMINISTRA | PO BOX 310502 DES MOINES, IA 503310502 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $48K | $48K | 2.11% |
| MERCER HEALTH AND BENEFITS, LLC5 Filed as: MERCER VOLUNTARY BENEFITS | 12421 MEREDITH DRIVE URBANDALE, IA 50398 | METROPOLITAN LIFE INSURANCE COMPANY | $45K | — | $45K | 2.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | P.O. BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 0.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON, PA | LOCKBOX #9102 P.O. BOX 8500 PHILADELPHIA, PA 191780001 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 0.43% |
| DICESARE AND ASSOCIATES3 Filed as: FJ DICESARE AGENCY LLC | P.O. BOX 10818 ROCHESTER, NY 14601 | EXCELLUS BLUECROSS BLUESHIELD | $9K | — | $9K | 3.55% |
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 | 3,224 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 977 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KEYSTONE HEALTH PLAN CENTRAL | 87 | $1.3M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,366 | $1.3M |
| Vision(2 contracts, 2 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 972 | $531K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 4,001 | $4.5M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 4,001 | $2.3M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 4,001 | $2.3M |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 87 | $495K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 4,001 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,001 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.