| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 310502 DES MOINES, IA 503310502 | METROPOLITAN LIFE INSURANCE COMPANY | — | $24 | $24 | 0.00% |
| POMS & ASSOCIATES INSURANCE BROKERS3 | 5700 CANOGA AVE SUITE 400 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $52K | — | $52K | 5.42% |
| LOCKTON COMPANIES, LLC3 | C/O COMMERCE BANK P.O. BOX 843844 KANSAS CITY, MO 641843844 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 8.79% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 4.06% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE SUITE 1200 DALLAS, TX 75201 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 2.24% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 1.85% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $444 | $444 | 0.19% |
| AON CONSULTING INC3 Filed as: AON INSURANCE AGENCY LLC | 39030 TREASURY CTR CHICAGO, IL 60694 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $56K | $56K | 68.18% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | TRIPLE S SALUD, INC. | $3K | — | $3K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Other services; Claims processing; Direct payment from the plan Service code 12 | — | $2.2M |
| MAYER HOFFMAN MCCANN PC EIN 43-1947695 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $25K |
| STATE STREET BANK & TRUST EIN 04-1867445 TRUSTEE | Trustee (directed); Direct payment from the plan; Other fees; Float revenue; Distribution (12b-1) fees; Investment management Service code 25 | — | $19K |
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 | 4,863 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4,335 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 52 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 3 | $53K |
| Vision(3 contracts, 2 carriers) | SURENCY LIFE AND HEALTH | 3,290 | $1.4M |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 9,790 | $3.7M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,490 | $122K |
| Prescription drug | TRIPLE S SALUD, INC. | 6 | $53K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 9,198 | $472K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 11,339 | $358K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,339 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.