| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY INC. | 1820 E 1ST STREET, SUITE 400 SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMAPNY | $3K | — | $3K | 3.69% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - CINCINNA | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMAPNY | $685 | — | $685 | 0.85% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMAPNY | $654 | — | $654 | 0.81% |
| JAMES D DAVIDSON3 Filed as: JAMES D. DAVIDSON | 1820 E 1ST STREET, SUITE 400 SANTA ANA, CA 92868 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMAPNY | $265 | — | $265 | 0.33% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $565 | — | $565 | 0.70% |
| EOI SERVICE COMPANY INC3 | 1820 E 1ST STREET, SUITE 400 SANTA ANA, CA 92705 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $2 | $3K | 5.45% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - CINCINNA | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $866 | — | $866 | 1.37% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $814 | — | $814 | 1.29% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY INC. | 1820 E 1ST STREET, SUITE 400 SANTA ANA, CA 92705 | FIRST UNUM LIFE INSURANCE COMPANY | $777 | — | $777 | 3.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - CINCINNA | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIRST UNUM LIFE INSURANCE COMPANY | $179 | — | $179 | 0.92% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | FIRST UNUM LIFE INSURANCE COMPANY | $98 | — | $98 | 0.50% |
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 | 1,862 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,888 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,862 | $89K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 2,208 | $81K |
| Life insurance(3 contracts, 3 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 1,348 | $512K |
| Short-term disability(3 contracts, 3 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 1,348 | $501K |
| Long-term disability(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 1,348 | $431K |
| Other(4 contracts, 4 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 1,862 | $520K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,208 | — |
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.