| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MEDCOST BENEFIT SERVICES | 165 KIMEL PARK DRIVE SUITE 100 WINSTON-SALEM, NC 27103 | UNIMERICA INSURANCE COMPANY | $10K | — | $10K | — |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER HEALTH & BENEFITS LLC | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | COMMUNITY EYE CARE | $10K | — | $10K | — |
| AON CONSULTING INC Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | COMMUNITY EYE CARE | $8K | — | $8K | — |
| AON CONSULTING INC | 29840 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE | $78K | $2K | $80K | — |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE | $39K | — | $39K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDCOST BENEFIT SERVICES EIN 56-2056821 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 165 KIMEL PARK DRIVE SUITE 100 WINSTON-SALEM, NC 27103 | $406K |
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 | 1,601 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,601 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | COMMUNITY EYE CARE | 1,887 | $0 |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE | 1,535 | $0 |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE | 1,535 | $0 |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 1,306 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,887 | — |
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.