| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | $123K | $24K | $147K | 11.64% |
| DAVID M COUGHLIN3 | 4253 HUNT DR APT 1607 CARROLLTON, TX 75010 | CONTINENTAL AMERICAN INSURANCE CO | $11K | — | $11K | 5.43% |
| DEELORALEE A COUGHLIN3 Filed as: DEELORALEE COUGHLIN | 4906 N 139TH AVE OMAHA, NE 68164 | CONTINENTAL AMERICAN INSURANCE CO | $3K | — | $3K | 1.66% |
| MITCHELL FRIEHE & ASSOCIATES INC3 Filed as: MITCHELL FRIEHE & ASSOCIATES | 16909 PALISADE S DR OMAHA, NE 68136 | CONTINENTAL AMERICAN INSURANCE CO | $3K | — | $3K | 1.48% |
| MARY E MERICA3 | 5211 N 150 ST OMAHA, NE 68116 | CONTINENTAL AMERICAN INSURANCE CO | $3K | — | $3K | 1.41% |
| DIANE BANG3 | 7350 N 156TH ST BENNINGTON, NE 68007 | CONTINENTAL AMERICAN INSURANCE CO | $2K | — | $2K | 0.81% |
| DAVID J MCCLELLAN3 Filed as: DAVID J BECK | 16636 FREDERICK CIRCLE OMAHA, NE 68130 | CONTINENTAL AMERICAN INSURANCE CO | $1K | — | $1K | 0.74% |
| MARK FRIEHE3 | 4611 S 96TH ST STE 101 OMAHA, NE 68127 | CONTINENTAL AMERICAN INSURANCE CO | $805 | — | $805 | 0.41% |
| DANIEL B ELLIS3 | 751 HEBRON PARKWAY STE 220 LEWISVILLE, TX 75057 | CONTINENTAL AMERICAN INSURANCE CO | $702 | — | $702 | 0.36% |
| MARY E MERICA3 Filed as: MARY MERICA | 5211 N 150 ST OMAHA, NE 68116 | CONTINENTAL AMERICAN INSURANCE CO | $699 | — | $699 | 0.36% |
| THOMAS E SHEFFIELD3 | PO BOX 151 MCCOOL JUNCTION, NE 68401 | CONTINENTAL AMERICAN INSURANCE CO | $651 | — | $651 | 0.33% |
| CYNTHIA D WELKEN-PLACE3 | 14710 WEST DODGE ROAD, SUITE 200 OMAHA, NE 68154 | CONTINENTAL AMERICAN INSURANCE CO | $478 | — | $478 | 0.24% |
| ANN C BECK3 | 15606 ELM ST STE 105 OMAHA, NE 68130 | CONTINENTAL AMERICAN INSURANCE CO | $449 | — | $449 | 0.23% |
| MICHAEL COPPESS3 | 4910 DODGE ST STE 107 OMAHA, NE 68132 | CONTINENTAL AMERICAN INSURANCE CO | $93 | — | $93 | 0.05% |
| KARMIE K COUGHLIN3 | 4253 HUNT DR APT 1607 CARROLLTON, TX 75010 | CONTINENTAL AMERICAN INSURANCE CO | $57 | — | $57 | 0.03% |
| MICHAEL S CEJKA3 | 613 CEDAR ST HICKMAN, NE 68372 | CONTINENTAL AMERICAN INSURANCE CO | $48 | — | $48 | 0.02% |
| KIMBERLY DIAN CROCKETT3 Filed as: KIMBERLY D CROCKETT | 732 SILVER SANDS DR CORDOVA, TN 38018 | CONTINENTAL AMERICAN INSURANCE CO | $38 | — | $38 | 0.02% |
| ENROLLMENT SOLUTIONS LTD3 | 14 WUNSCHEL DRIVE SUTTON, MA 01590 | COLONIAL LIFE & ACCIDENT INSURANCE | $366 | — | $366 | 2.53% |
| DAVID L FLEURY3 | 545 SOUTH WATER ST PROVIDENCE, RI 02903 | COLONIAL LIFE & ACCIDENT INSURANCE | $181 | — | $181 | 1.25% |
| NATALIE JONES TELTOW3 | 1742 WICKHAM REACH DR SPRING, TX 77386 | COLONIAL LIFE & ACCIDENT INSURANCE | $20 | — | $20 | 0.14% |
| LAURIE J BURNS3 | 303 PLYLER RD INDIAN TRAIL, NC 28079 | COLONIAL LIFE & ACCIDENT INSURANCE | $3 | — | $3 | 0.02% |
| STEPHANIE DECHRISTOFARO | 1105 ACHIEVER CIRCLE SPRING HILL, TN 37174 | COLONIAL LIFE & ACCIDENT INSURANCE | $2 | — | $2 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $1.6M |
| CIGNA EIN 06-0303370 NONE | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Redemption fees Service code 12 | — | $89K |
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 | 2,062 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,062 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA | 440 | $64K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 4,683 | $1.3M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 4,683 | $1.3M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 4,683 | $1.3M |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO | 2,062 | $3.3M |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 4,683 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,683 | — |
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.