| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 650823 DALLAS, TX 752650823 | METROPOLITAN LIFE INSURANCE COMPANY | — | $127 | $127 | 0.01% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 310502 DES MOINES, IA 503310502 | METROPOLITAN LIFE INSURANCE COMPANY | — | $99 | $99 | 0.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 850823 DALLAS, TX 752650823 | METROPOLITAN LIFE INSURANCE COMPANY | — | $129 | $129 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 11.12% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | SUITE 900 444 W 47TH STREET KANSAS CITY, MO 641121906 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 5.37% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 2.90% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH SALDANA INC | 701 AVE PONCE DE LEON SAN JUAN, PR 007053256 | TRIPLE S SALUD, INC. | $4K | — | $4K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Other services; Direct payment from the plan; Claims processing Service code 12 | — | $2.1M |
| CBIZ CPAS P.C. EIN 43-1947695 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $42K |
| STATE STREET BANK & TRUST EIN 04-1867445 TRUSTEE | Float revenue; Distribution (12b-1) fees; Investment management; Other fees; Direct payment from the plan; Trustee (directed) Service code 25 | — | $15K |
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 | 5,785 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,411 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 8,196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | TRIPLE S SALUD, INC. | 6 | $103K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $2K |
| Vision(3 contracts, 2 carriers) | SURENCY LIFE AND HEALTH | 3,638 | $1.2M |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 4,656 | $3.2M |
| Short-term disability(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NY | 607 | $54K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 154 | $26K |
| Prescription drug | TRIPLE S SALUD, INC. | 6 | $84K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 4,211 | $908K |
| Other(3 contracts, 3 carriers) | UNITED BEHAVIORAL HEALTH DBA OPTUM | 15,647 | $414K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,647 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.