| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHARON BOHLMAN3 | 9410 TALISMAN DR VIENNA, VA 221823419 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.03% |
| SHARON BOHLMAN3 | 9410 TALISMAN DR VIENNA, VA 221823419 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 8.31% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | NATIONAL UNION FIRE INS. CO OF PITTSBURGH, PA | $609 | — | $609 | 24.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA INC EIN 54-0357120 INSURANCE PROVIDER | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Other fees Service code 12 | — | $489K |
| PAYFLEX SYSTEMS USA, INC. EIN 91-1774434 CLAIMS PROCESSOR | Contract Administrator; Claims processing Service code 12 | — | $13K |
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 | 1,308 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,329 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 7 | $92K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,298 | $1.0M |
| Vision | UNICARE LIFE & HEALTH INSURANCE COMPANY | 920 | $81K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,308 | $574K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,308 | $190K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,308 | $287K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 661 | $582K |
| Other(9 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,310 | $295K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,298 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.