| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $37K | $37K | 1.69% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $68 | $68 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $38 | $38 | 0.00% |
| VARIOUS - SEE ATTACHMENT3 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $361 | $7K | 9.82% |
| SPETNER ASSOCIATES INC3 Filed as: SPETNER, JONATHAN, SAMUEL | 8630 DELMAR BLVD STE 100 ST LOUIS, MO 63124 | FIRST UNUM LIFE INSURANCE COMPANY | $35 | — | $35 | 2.76% |
| LOCKTON COMPANIES, LLC3 | PO BOX 505115 ST LOUIS, MO 63150 | FIRST UNUM LIFE INSURANCE COMPANY | $23 | — | $23 | 1.82% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 217 | $723K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 4,922 | $2.2M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 4,922 | $2.2M |
| Life insurance(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 3,093 | $999K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 217 | $67K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3,128 | $504K |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 3,093 | $932K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,922 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.