| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $504 | $504 | 0.05% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE COMPANY | $12K | — | $12K | 9.22% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA INTERNATIONAL | $6K | — | $6K | 10.77% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - SAN FRAN | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $466 | $34 | $500 | 5.37% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE, STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $200 | — | $200 | 2.15% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 N FIRST ST SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $188 | — | $188 | 2.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - SAN FRAN | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $192 | $18 | $210 | 2.74% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE, STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $105 | — | $105 | 1.37% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 N FIRST ST SAN JOSE, CA 95112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.68% |
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 | 1,462 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,478 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | AETNA LIFE INSURANCE CO. | 2,595 | $20.7M |
| Dental(3 contracts, 3 carriers) | DELTA DENTAL OF CALIFORNIA | 3,348 | $2.1M |
| Vision(3 contracts, 3 carriers) | VISION SERVICE PLAN | 1,240 | $452K |
| Life insurance(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,458 | $1.1M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,458 | $1.1M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,458 | $1.1M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 462 | $2.7M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,458 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,348 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.