| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 333 W WACKER DR STE 1950 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $44K | — | $44K | 7.66% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 17901 VON KARMAN AVE STE1100 IRVINE, CA 92614 | HARTFORD LIFE AND ACCIDENT | $14K | $0 | $14K | 2.40% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING IN | 4565 PAYSPHERE CIRCLE STE 1100 IRVINE, CA 92614 | HARTFORD LIFE AND ACCIDENT | $0 | $641 | $641 | 0.11% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL ST FL 2 BOSTON, MA 021101700 | VISION SERVICE PLAN | $0 | $0 | $0 | 0.00% |
| CARIE ANN CASSAR3 | 926 SANTIAGO AVE LONG BEACH, CA 90804 | AFLAC | $25K | $0 | $25K | 24.54% |
| KELLY V ZURZOLO3 | 875 FEINBERG CT STE 103 CARY, IL 60013 | AFLAC | $7K | $0 | $7K | 7.08% |
| MOLOKAI MYLES HAND3 | 1409 S LAMAR ST APT 716 DALLAS, TX 75215 | AFLAC | $5K | $0 | $5K | 5.00% |
| WILLIE F BEVERLY3 | 15300 PINE TREE WAY BOWIE, MD 20721 | AFLAC | $3K | $0 | $3K | 2.63% |
| CASSANDRA GREEN3 | 10541 CALLE LEE STE 125 LOS ALAMITOS, CA 90720 | AFLAC | $1K | $0 | $1K | 1.19% |
| MICHAEL E MCCARTHY3 | PO BOX 1047 DUNDEE, IL 60118 | AFLAC | $996 | $0 | $996 | 0.96% |
| KANDACE M MCCARTHY3 | PO BOX 1047 DUNDEE, IL 60118 | AFLAC | $794 | $0 | $794 | 0.77% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DR WEST RIVER, MD 20778 | AFLAC | $561 | $0 | $561 | 0.54% |
| CAROLIN BERMUDEZ3 | 703 ETHAN ALLEN AVE APT 302 TAKOMA PARK, MD 20912 | AFLAC | $415 | $0 | $415 | 0.40% |
| MATTHEW W EVANS3 | 1344 ASHTON RD STE 200 HANOVER, MD 21076 | AFLAC | $373 | $0 | $373 | 0.36% |
| KAREN MYERS3 | 8007 MORNINGSIDE DR FREDERICK, CO 80516 | AFLAC | $172 | $0 | $172 | 0.17% |
| CORY CORTES3 | 9620 COPLEY DR INDIANAPOLIS, IN 46290 | AFLAC | $100 | $0 | $100 | 0.10% |
| DONNA BONNE3 | 88 W MAPLE AVE DENVER, CO 80223 | AFLAC | $34 | $0 | $34 | 0.03% |
| CHRISTOPHER M. ALLEN3 Filed as: CHRISTOPHER JOHN CULLINAN | 49 FOTTLER RD HINGHAM, MA 02043 | AFLAC | $34 | $0 | $34 | 0.03% |
| COLLEEN M KIRKLAND3 Filed as: COLLEEN MEILING LAWS | 1932 E DEERE AVE STE 240 SANTA ANA, CA 92705 | AFLAC | $33 | $0 | $33 | 0.03% |
| SAMUEL B BANKS3 | 637 E 1ST ST UNIT C1 BOSTON, MA 02127 | AFLAC | $26 | $0 | $26 | 0.03% |
| LARRY W NICHOLSON3 | 116 E MAIN ST ROCK HILL, SC 29730 | AFLAC | $22 | $0 | $22 | 0.02% |
| P MICHAEL MARTINDALE3 | 730 MOHAWK HILLS DR APT C CARMEL, IN 46032 | AFLAC | $12 | $0 | $12 | 0.01% |
| EVAN D CROSS3 | 377 K ST UNIT 1 BOSTON, MA 02127 | AFLAC | $12 | $0 | $12 | 0.01% |
| DAVID S HALLETT3 | 8 BROOKS ST WINCHESTER, MA 01890 | AFLAC | $8 | $0 | $8 | 0.01% |
| MATTHEW D SMITH3 | 9620 COPLEY DR INDIANAPOLIS, IN 46290 | AFLAC | $7 | $0 | $7 | 0.01% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 10.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET 2ND FLOOR BOSTON, MA 02110 | HYATT LEGAL PLANS | $3K | $381 | $3K | 10.14% |
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION | SYSTEMS, INC. 99 PARK AVE FL 25 NEW YORK, NY 10016 | HYATT LEGAL PLANS | $0 | $146 | $146 | 0.45% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE SERVICES, INC. | 160 FEDERAL STREET 2ND FLOOR BOSTON, MA 02110 | HYATT LEGAL PLANS | — | $130 | $130 | 0.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 NORTH SCOTTSDALE ROAD SUITE 600 PHOENIX, AZ 85254 | HYATT LEGAL PLANS | — | $105 | $105 | 0.33% |
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 | 2,115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 831 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,968 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 414 | $99K |
| Vision | VISION SERVICE PLAN | 1,325 | $147K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 7,498 | $576K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 7,498 | $576K |
| Other(5 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 7,498 | $849K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,498 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.