| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 0.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US, LLC | P.O. BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 0.73% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $94 | $94 | 0.01% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN, AVE, STE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $16 | $16 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US, LLC | LOCKBOX #28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $409 | $409 | 0.25% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $64 | $64 | 0.04% |
| RICKEY L. REDEKER3 | 6 CORBETT AVENUE IRWIN, PA 15642 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10K | — | $10K | 12.26% |
| BUCK GLOBAL LLC3 Filed as: BUCK GLOBAL, LLC | P.O. BOX 207640 DALLAS, TX 753207640 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $22 | — | $22 | 0.03% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 101 PARK AVENUE 12TH FLOOR NEW YORK, NY 10016 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES LLC EIN 41-1289245 N/A | Other services; Claims processing Service code 12 | — | $509K |
| DEAN DORTON ALLEN FORD, PLLC EIN 27-3858252 N/A | Accounting (including auditing) Service code 10 | — | $34K |
| NORTHERN TRUST CORPORATION N/A | Contract Administrator Service code 13 | 50 SOUTH LA SALLE STREET CHICAGO, IL 60603 | $16K |
| CONNECTICUT GENERAL LIFE INSURANCE EIN 06-0303370 N/A | Other services; Named fiduciary; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan; Non-monetary compensation Service code 12 | — | $12K |
| KPMG EIN 13-5565207 N/A | Accounting (including auditing) Service code 10 | — | $9K |
| FROST BROWN TODD N/A | Legal Service code 29 | P.O. BOX 70087 LOUISVILLE, KY 402700087 | $5K |
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 | 509 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 729 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED BEHAVIORAL HEALTH, DBA OPTUM | 509 | $14K |
| Vision | VISION SERVICE PLAN | 438 | $95K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,644 | $1.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 509 | $167K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE CO OF NY | 600 | $431K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,644 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,644 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.