| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH & BENEFITS ADMIN 4059 | PO BOX 310502 DES MOINES, IA 50331 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $457 | $10K | 5.25% |
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH & BENEFITS ADMIN 4059 | PO BOX 310502 DES MOINES, IA 50331 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $449 | $9K | 5.26% |
| MARSHALL GROUP INC4 Filed as: MARSHALL GROUP, INCL | 265 N 700 W BLACKFOOT, ID 83221 | PRE-PAID LEGAL SERVICES, INC DBA LEGAL SHIELD | $6K | — | $6K | 11.66% |
| CLEARWATER BENEFITS LLC4 Filed as: CLEARWATER BENEFITS, LLC | PO BOX 347 MERIDIAN, ID 83680 | PRE-PAID LEGAL SERVICES, INC DBA LEGAL SHIELD | $45 | — | $45 | 0.09% |
| EVA SUE THOMAS4 | 669 W 200 N BLACKFOOT, ID 83224 | PRE-PAID LEGAL SERVICES, INC DBA LEGAL SHIELD | $23 | — | $23 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVE. HARTFORD, CT 06156 | $1.6M |
| PAYFLEX EIN 91-1777443 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 10802 FARNAM DRIVE OMAHA, NE 68154 | $34K |
| AETNA BEHAVIORAL HEALTH, LLC EIN 20-0446713 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVE. RSAA HARTFORD, CT 06156 | $25K |
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 | 1,520 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 236 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,756 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF IDAHO | 1,197 | $2.1M |
| Vision | VISION SERVICE PLAN | 1,283 | $342K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,751 | $1.3M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,751 | $1.3M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 786 | $539K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,751 | $701K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,751 | — |
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.