| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHOICE BENEFITS INC3 | 9007 BRITTANY WAY TAMPA, FL 33619 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $46K | $0 | $46K | 17.83% |
| CHOICE BENEFITS INC3 Filed as: CHOICE BENEFITS | 9007 BRITTANY WAY TAMPA, FL 33619 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | $0 | $10K | 9.87% |
| CHOICE BENEFITS INC3 | 9007 BRITTANY WAY TAMPA, FL 33619 | TRANSAMERICA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 21.52% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4 EMBARCADERO CTR SUITE 40 SAN FRANCISCO, CA 94111 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 6.88% |
| EXCELSIOR BENEFITS LLC3 | 23505 SMITHTOWN RD SUITE 200 EXCELSIOR, MN 55331 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.67% |
| DOMENIC SALVATO3 | 500 OFFICE CENTER DR 4TH FLOOR FORT WASHINGTON, PA 19034 | TRANSAMERICA LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 15.39% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 15.40% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 15.91% |
| MERCER HEALTH AND BENEFITS, LLC7 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 28.48% |
| CHOICE BENEFITS INC3 | 9007 BRITTANY WAY TAMPA, FL 33619 | METLIFE LEGAL PLANS, INC. | $422 | $0 | $422 | 9.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METLIFE LEGAL PLANS, INC. | $0 | $8 | $8 | 0.19% |
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 | 644 | 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) | 644 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 155 | $258K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 149 | $102K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 149 | $102K |
| Life insurance(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 644 | $69K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 60 | $28K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 44 | $10K |
| Other(3 contracts, 3 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 644 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 644 | — |
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.