| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $6K | $6K | 0.10% |
| WORTHAM SAN ANTONIO INC7 Filed as: JOHN L WORTHAM & SON LP | PO BOX 301598 DALLAS, TX 75303 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $150K | — | $150K | 4.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 N/A | Direct payment from the plan; Contract Administrator Service code 13 | — | $940K |
| MERCER HR SERVICES LLC EIN 20-1932099 N/A | Direct payment from the plan; Plan Administrator Service code 14 | — | $884K |
| LOOMIS SAYLES TRUST COMPANY EIN 20-8080381 N/A | Investment management fees paid directly by plan Service code 51 | — | $224K |
| ANALYTIC INVESTORS, LLC EIN 95-2665790 N/A | Investment management fees paid directly by plan Service code 51 | — | $181K |
| EXPRESS SCRIPTS EIN 22-3461740 N/A | Contract Administrator; Direct payment from the plan Service code 13 | — | $157K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 26-4310632 N/A | Investment management fees paid directly by plan Service code 51 | — | $134K |
| HAM, LANGSTON & BREZINA LLP EIN 76-0448495 N/A | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $36K |
| STOEL RIVES EIN 93-0408771 N/A | Legal; Direct payment from the plan Service code 29 | — | $29K |
| MERCER INVESTMENT CONSULTING LLC EIN 61-0736136 N/A | Investment management fees paid directly by plan Service code 51 | — | $25K |
| OPTUMHEALTH FINANCIAL SERVICES INC EIN 47-0858530 N/A | Contract Administrator; Direct payment from the plan Service code 13 | — | $22K |
| AARP EIN 98-1985500 N/A | Direct payment from the plan; Contract Administrator Service code 13 | — | $22K |
| BRACEWELL LLP EIN 74-1024827 N/A | Legal; Direct payment from the plan Service code 29 | — | $21K |
| STATE STREET BANK AND TRUST COMPANY EIN 04-1867445 N/A | Trustee (directed); Direct payment from the plan; Investment management; Float revenue Service code 25 | — | $18K |
| COMMPSYCH EIN 35-3739783 N/A | Contract Administrator Service code 13 | — | $0 |
| MERCER HEALTH & BENEFITS LLC EIN 13-2834414 N/A | Consulting (general) Service code 16 | — | $0 |
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 | 443 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13,181 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 13,624 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 2,724 | $4.6M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,197 | $6.6M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 10,879 | $3.0M |
| Other | CIGNA LIFE INSURANCE CO. OF NEW YORK | 106 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,879 | — |
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."
No prospect flags tripped on this filing.