| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | UNKNOWN ARLINGTON, VA 22201 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $2K | $2K | 0.05% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 601478 CHARLOTTE, NC 28260 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $27K | — | $27K | 2.00% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203510 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $21K | $21K | 2.56% |
| MERCER HEALTH AND BENEFITS, LLC3 | 1166 AVENUE OF THE AMERICAS 22ND FLOOR NEW YORK, NY 10036 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $2K | — | $2K | 25.01% |
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 | 637 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 642 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 571 | $5.0M |
| Dental | DELTA DENTAL OF VIRGINIA | 950 | $448K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 571 | $3.6M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 493 | $806K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 493 | $806K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 493 | $806K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 571 | $4.9M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 637 | $938K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 950 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.