| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $256K | $0 | $256K | 6.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $0 | $70K | $70K | 1.64% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $24K | $4K | $29K | 2.24% |
| DANIEL WARD RICHARDSON3 Filed as: DANIEL RICHARDSON | 11111 CARMEL COMMONS BOULEVARD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 0.25% |
| JAMES WILLIAM DEUINK3 Filed as: JAMES DEUINK | 11111 CARMEL COMMONS BOULEVARD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 0.24% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BOULEVARD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 0.23% |
| LOUIS R FAIOLA3 Filed as: LOUIS PANTALONE | PO BOX 1116 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 0.00% |
| DANIEL WARD RICHARDSON3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29K | $0 | $29K | 4.17% |
| GREG I HINRICHS3 Filed as: GREG I. HINRICHS | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | $362 | $28K | 4.10% |
| JAMES WILLIAM DEUINK3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | $0 | $28K | 4.07% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE SUIITE 2 HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 1.17% |
| DANIEL WARD RICHARDSON3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27K | $0 | $27K | 4.94% |
| GREG I HINRICHS3 Filed as: GREG I. HINRICHS | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $26K | $365 | $26K | 4.83% |
| JAMES WILLIAM DEUINK3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $26K | $0 | $26K | 4.79% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE SUIITE 2 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $7K | $20K | 3.66% |
| GREG I HINRICHS3 Filed as: GREG I. HINRICHS | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $18K | $29K | 18.40% |
| DANIEL WARD RICHARDSON3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $0 | $11K | 7.31% |
| JAMES WILLIAM DEUINK3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $0 | $11K | 7.09% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE SUIITE 2 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | ACE AMERICAN INSURANCE COMPANY | $6K | — | $6K | 20.00% |
| GREG I HINRICHS3 Filed as: GREG I. HINRICHS | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $54 | $292 | $346 | 31.45% |
| DANIEL WARD RICHARDSON3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $55 | $0 | $55 | 5.00% |
| JAMES WILLIAM DEUINK3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $54 | $0 | $54 | 4.91% |
| GREG I HINRICHS3 Filed as: GREG I. HINRICHS | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $107 | $127 | 17.12% |
| DANIEL WARD RICHARDSON3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 2.83% |
| JAMES WILLIAM DEUINK3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 2.70% |
| GREG I HINRICHS3 Filed as: GREG I. HINRICHS | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $10K | $12K | — |
| DANIEL WARD RICHARDSON3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | — |
| JAMES WILLIAM DEUINK3 | 11525 NORTH COMMUNITY HOUSE ROAD SUITE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | — |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE SUIITE 2 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $654 | $0 | $654 | — |
| IVAN C HINRICHS3 | 11111 CARMEL COMMONS BOULEVARD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | — |
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 | 5,513 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 140 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,656 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 4,140 | $635K |
| Life insurance(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 5,551 | $6.1M |
| Short-term disability(6 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 5,551 | $5.7M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 5,551 | $4.3M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 5,551 | $5.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,551 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.