| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLMARK INC3 | PO BOX 10481 DES MOINES, IA 50306 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $332 | — | $332 | 1.15% |
| WELLMARK INC3 | PO BOX 10481 DES MOINES, IA 50306 | DEARBORN NATIONAL LIFE INSURANCE | $319 | — | $319 | 3.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Claims processing; Contract Administrator Service code 12 | — | $3.7M |
| MERCER HEALTH AND BENEFITS EIN 20-1932099 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $813K |
| ACTIVE HEALTH MANAGEMENT EIN 52-2182411 NONE | Participant communication; Consulting (general) Service code 16 | — | $204K |
| AETNA BEHAVIORAL HEALTH, LLC EIN 20-0446713 NONE | Plan Administrator Service code 14 | — | $140K |
| PAYFLEX EIN 91-1774434 NONE | Claims processing Service code 12 | — | $117K |
| BNY MELLON TRUST COMPANY EIN 95-3571558 NONE | Investment management; Trustee (directed) Service code 25 | — | $55K |
| FIDELITY INVESTMENTS INSTIUTIONAL EIN 04-2647786 NONE | Plan Administrator Service code 14 | — | $44K |
| WEAVER EIN 75-0786316 NONE | Accounting (including auditing) Service code 10 | — | $37K |
| AETNA, INC. EIN 23-2229683 NONE | Contract Administrator Service code 13 | — | $6K |
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 | 4,620 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,720 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,340 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | AETNA INTERNATIONAL | 536 | $5.3M |
| Dental(2 contracts) | AETNA INTERNATIONAL | 536 | $4.7M |
| Vision(3 contracts, 2 carriers) | AETNA INTERNATIONAL | 3,165 | $5.3M |
| Life insurance(3 contracts, 3 carriers) | AETNA INTERNATIONAL | 536 | $4.2M |
| Short-term disability(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 54 | $37K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE | 28 | $8K |
| Prescription drug(3 contracts, 2 carriers) | AETNA INTERNATIONAL | 536 | $5.3M |
| Other(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 54 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,165 | — |
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.