| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $897 | $897 | 0.05% |
| XEROX CORPORATION3 | BUCK CONSULTANTS, LLC P.O. BOX 202617 IRVING, TX 75320 | HYATT LEGAL PLANS | $9K | $0 | $9K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 606740001 | HYATT LEGAL PLANS | $0 | $87 | $87 | 0.09% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 606740001 | HYATT LEGAL PLANS | $0 | $41 | $41 | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 606740001 | HYATT LEGAL PLANS | $0 | $38 | $38 | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 27447 NEW YORK, NY 100877447 | METROPOLITAN LIFE INSURANCE COMPANY | $745 | $0 | $745 | 9.14% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH EXECUTIVE BENEFITS INC | PO BOX 27447 NEW YORK, NY 100877447 | METROPOLITAN LIFE INSURANCE COMPANY | $359 | $0 | $359 | 4.40% |
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 | 2,539 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 217 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,756 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,057 | $4.8M |
| Dental | DELTA DENTAL OF DISTRICT OF COLUMBIA | 3,351 | $1.4M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,539 | $1.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,539 | $1.6M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,539 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,351 | — |
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.