| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 318 E CARRUTH LANE DOUBLE OAK, TX 75077 | HARTFORD LIFE AND ACCIDENT | $0 | $16K | $16K | 2.82% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $9K | $0 | $9K | 1.57% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 318 E CARRUTH LANE DOUBLE OAK, TX 75077 | HARTFORD LIFE AND ACCIDENT | $3K | $0 | $3K | 0.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 0.48% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 318 E CARRUTH LANE DOUBLE OAK, TX 75077 | HARTFORD LIFE AND ACCIDENT | $0 | $10K | $10K | 1.94% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 0.21% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 318 E CARRUTH LANE DOUBLE OAK, TX 75077 | HARTFORD LIFE AND ACCIDENT | $0 | $12K | $12K | 8.05% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFIT LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $5K | $0 | $5K | 3.11% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $0 | $747 | $747 | 0.49% |
| ACRISURE LLC3 | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN GENERAL INSURANCE COMPANY | $1K | $0 | $1K | 4.60% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION | PO BOX 850502 MINNEAPOLIS, MN 55485 | METROPOLITAN GENERAL INSURANCE COMPANY | $1K | $0 | $1K | 3.94% |
| ACRISURE LLC3 Filed as: ACRISURE LLC D/B/A ALLTRUST INS. | PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN GENERAL INSURANCE COMPANY | $491 | $0 | $491 | 1.53% |
| LBL INSURANCE SERVICES INC3 Filed as: LBL INSURANCE SERVICES, INC. | 3631 S. HARBOR BLVD STE 200 SANTA ANA, CA 92704 | METROPOLITAN GENERAL INSURANCE COMPANY | $0 | $302 | $302 | 0.94% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION, LLC | PO BOX 310502 DES MOINES, IA 50331 | METROPOLITAN GENERAL INSURANCE COMPANY | $0 | $84 | $84 | 0.26% |
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 | 637 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 282 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 919 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF ARIZONA | 112 | $30K |
| Life insurance(3 contracts) | HARTFORD LIFE AND ACCIDENT | 391 | $1.3M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 391 | $571K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 391 | $571K |
| Other(2 contracts, 2 carriers) | METROPOLITAN GENERAL INSURANCE COMPANY | 152 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 391 | — |
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.