| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEVEN RAY GRIFFIN3 Filed as: STEVEN RAY GRIFIN | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $92K | $17K | $109K | 17.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $31K | $2K | $33K | 5.20% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $5K | $20K | 3.17% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 EAST GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $248 | $0 | $248 | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 NORTH WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $0 | $12K | 2.12% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $5K | $0 | $5K | 0.81% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | ONE INVESTORS WAY NORWOD, MA 02062 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $21K | $4K | $25K | 5.47% |
| USI INSURANCE SERVICES LLC3 | 530 PRESTON AVENUE MERIDEN, CT 06450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 0.37% |
| STEVEN RAY GRIFFIN3 Filed as: STEVEN RAY GRIFIN | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $106K | $15K | $121K | 76.80% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27K | $3K | $30K | 19.02% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 EAST GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $70 | $0 | $70 | 0.04% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $30 | $39 | 0.02% |
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 | 1,161 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 105 | $566K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,028 | $448K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,028 | $448K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,348 | $795K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,348 | $638K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,348 | $638K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 105 | $566K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,348 | $638K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,348 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.