| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOMINIUM BENEFITS, LLC3 Filed as: DOMINIUM BENEFITS LLC | 3500 LENOX ROAD ATLANTA, GA 30326 | FEDERAL INSURANCE COMPANY | $46K | — | $46K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $46K | — | $46K | 15.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | PO BOX 310502 DES MOINES, IA 50331 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | — | $7K | 9.16% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC | DOMINIUM A DIV OF INTEGRO USA INC PO BOX 5682 CAROL STREAM, IL 60197 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 1.66% |
| DOMINIUM BENEFITS, LLC3 Filed as: DOMINIUM BENEFITS LLC | 3500 LENOX ROAD SUITE 1600 ATLANTA, GA 30326 | CONTINENTAL AMERICAN INSURANCE COMPANY | $45 | — | $45 | 10.07% |
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 | 3,955 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,491 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,446 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 215 | $81K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 8,154 | $3.2M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 8,154 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,154 | — |
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.