| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | $0 | $69K | $69K | 4.00% |
| CHILD HEALTH CORP OF AMERICA3 | 6803 W 64TH STREET, SUITE 208 SHAWNEE MISSION, KS 66202 | HARTFORD LIFE AND ACCIDENT | $17K | $0 | $17K | 0.96% |
| CHILD HEALTH CORP OF AMERICA3 | 6803 WEST 64TH STREET, SUITE 208 SHAWNEE MISSION, KS 66202 | HARTFORD LIFE AND ACCIDENT | $159K | $0 | $159K | 9.26% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | $0 | $69K | $69K | 4.00% |
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $405 | — | $405 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PARTNERS ADMINISTRATORS, INC EIN 41-1629390 PLAN ADMINISTRATOR | Plan Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.6M |
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 | 4,407 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 38 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH PARTNERS ADMINISTRATORS INC. | 8,323 | $141K |
| Dental | DELTA DENTAL PLAN OF MINNESOTA | 8,585 | $2.8M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,382 | $1.7M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 3,595 | $1.7M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,276 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,585 | — |
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.