| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET SUITE 1710 BOSTON, MA 02109 | HARTFORD LIFE AND ACCIDENT | — | $42K | $42K | 2.19% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFIT | 321 CLARK STREET 9TH FL STE 1710 CHICAGO, IL 60610 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $23K | — | $23K | 2.04% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET STE 1710 BOSTON, MA 02109 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 1.43% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFIT | 321 N CLARK STREET 9TH FL STE 1710 CHICAGO, IL 60610 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.07% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFIT | 321 N CLARK STREET 9TH FL STE 1710 CHICAGO, IL 60610 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $3K | — | $3K | 2.35% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 701 MARKET STREET SUITE 1100 ST LOUIS, MO 63101 | ACE AMERICAN INSURANCE COMPANY | $9K | — | $9K | 20.00% |
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 | 3,130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 74 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,349 | $598K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,810 | $1.9M |
| Short-term disability(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 927 | $282K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,809 | $1.1M |
| Other(4 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 3,136 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,136 | — |
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.