| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC | PO BOX 13784 NEWARK, NJ 07188 | UNITEDHEALTHCARE INSURANCE COMPANY | $82K | — | $82K | 4.87% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | UNITEDHEALTHCARE INSURANCE COMPANY | -$248 | — | -$248 | -0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | — | $15K | $15K | 1.59% |
| USI INSURANCE SERVICES LLC3 | 470 PARK AVE SOUTH FLOOR 6 NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | — | $9K | $9K | 0.92% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON-POTOMAC, MD | 12505 PARK POTOMAC AVENUE POTOMAC, MD 20854 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $10K | — | $10K | 9.20% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS-NY | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $400 | — | $400 | 0.37% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS-ADMIN | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | — | $1 | $1 | 0.00% |
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 | 1,143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 42 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 446 | $1.7M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 446 | $1.7M |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 1,624 | $109K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 879 | $1.1M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 879 | $932K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 879 | $932K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 446 | $1.7M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 879 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,624 | — |
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.