| 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 | — | $522 | $522 | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE COMPANY | $20K | — | $20K | 10.24% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA INTERNATIONAL | $15K | — | $15K | 9.46% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $88 | $1K | 9.27% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE, STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $395 | $38 | $433 | 3.11% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 N FIRST ST SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $206 | $2 | $208 | 1.49% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $637 | $66 | $703 | 7.27% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE, STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $96 | — | $96 | 0.99% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 N FIRST ST SAN JOSE, CA 95112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.41% |
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 | 1,482 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,509 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 428 | $2.6M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 38 | $355K |
| Vision(3 contracts, 3 carriers) | VISION SERVICE PLAN | 1,261 | $701K |
| Life insurance(5 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,481 | $1.7M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,481 | $1.4M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,481 | $1.4M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 428 | $2.4M |
| Other(5 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,481 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,481 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.