| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $3K | $12K | 5.61% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, J | CUSTOM BENEFITS PROGRAMS INC PO BOX 1116 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 93245 NETWORK PL CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $812 | — | $812 | 0.38% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS-TAMPA | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $481 | — | $481 | 0.23% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS-LAKE MARY | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $479 | — | $479 | 0.23% |
| CFN AGENCY INC3 Filed as: CFN AGENCY INC. | 4450 RIVER FREEN PKWY STE 100A DULUT, GA 30096 | AETNA LIFE INSURANCE COMPANY | $9K | — | $9K | 5.53% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $78 | — | $78 | 4.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS-LAKE MARY | 4565 PAYSHPERE CIRCLE CHICAGO, IL 60674 | FIRST UNUM LIFE INSURANCE COMPANY | $18 | — | $18 | 0.94% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, J | CUSTOM BENEFIT PROGRAMS INC PO BOX 1116 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $32 | — | $32 | 1.72% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $13 | — | $13 | 0.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | PO BOX 93234 CHICAGO, IL 60673 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $6 | — | $6 | 0.32% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - TAMPA | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $1 | — | $1 | 0.05% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS-LAKE MARY | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $81 | — | $81 | 7.11% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $32 | $59 | 5.18% |
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 | 20,987 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 66 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 21,067 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF HAWAII | 1 | $9K |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 447 | $274K |
| Vision(4 contracts, 3 carriers) | EYEMED | 7,028 | $688K |
| Life insurance(4 contracts, 4 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 5,816 | $900K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 9 | $2K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 5,701 | $1.0M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF HAWAII | 1 | $9K |
| Other(7 contracts, 6 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 24,226 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 24,226 | — |
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.