| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 21300 VICTORY BLVD SUITE 635 WOODLAND HILLS, CA 91367 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $258K | — | $258K | 4.01% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 0.06% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1120 SANCTUARY PKWY, STE. 300 ALPHARETTA, GA 300047631 | RELIASTAR LIFE INSURANCE COMPANY(VOYA) | $109K | — | $109K | 3.67% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GROUP | 1120 SANCTUARY PKWY., STE. 300 ALPHARETTA, GA 300097630 | RELIASTAR LIFE INSURANCE COMPANY(VOYA) | — | $67K | $67K | 2.26% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIASTAR LIFE INSURANCE COMPANY(VOYA) | $10K | — | $10K | 0.33% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES | 321 N. CLARK STREET SUITE 940 CHICAGO, IL 60654 | EYEMED VISION CARE (COMBINED INSURANCE COMPANY OF AMERICA) | $120K | — | $120K | 9.15% |
| PACIFIC RES BENEFITS ADVY LLC3 | 321 N. CLARK STREET SUITE 940 CHICAGO, IL 60654 | ALLSTATE WORKPLACE DIVISION | $62K | — | $62K | 9.33% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 1000 RIDGEWAY LOOP ROAD MEMPHIS, TN 38120 | BLUE CARE NETWORK OF MICHIGAN | $21K | — | $21K | 3.71% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS HOUSTON LLC | 1120 SANCTUARY PKWY SUITE 300 ALPHARETTA, GA 30004 | HARTFORD LIFE AND ACCIDENT | $52K | — | $52K | 12.34% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $11K | — | $11K | 2.66% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES | 321 N CLARK ST. SUITE 940 CHICAGO, IL 60654 | LEGALPLANS, USA | $13K | — | $13K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 871 RIDGEWAY LOOP RD SUITE 212 MEMPHIS, TN 38120 | $7.0M |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 240 VENTURE CIRCLE NASHVILLE, TN 37228 | $286K |
| COMPSYCH EIN 35-3739783 TPA | Recordkeeping fees Service code 64 | — | $0 |
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 | 13,023 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 13,023 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | KAISER FOUNDATION HEALTH PLANS INC SO CA | 582 | $6.3M |
| Vision | EYEMED VISION CARE (COMBINED INSURANCE COMPANY OF AMERICA) | 5,787 | $1.3M |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 19,841 | $9.4M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 13,023 | $6.4M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 13,023 | $6.4M |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 124 | $560K |
| Other(3 contracts, 3 carriers) | ALLSTATE WORKPLACE DIVISION | 2,450 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 19,841 | — |
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.