| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 125 OTTAWA AVE NW SUITE 400 CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $33K | — | $33K | 1.25% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 0.06% |
| LEGAL BENEFITS STOLTZ LLC4 | 8390 E VIA DE VENTURA SUITE 205 SCOTTSDALE, AZ 85258 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $31K | — | $31K | 22.80% |
| RHONA S UNSELL INC4 Filed as: RHONA S. UNSELL INC. | 6525 GUNPARK DR. SUITE 370-152 BOULDER, CO 80301 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $29 | — | $29 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 8.00% |
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 | 4,379 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 37 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $16K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,448 | $280K |
| Vision | VISION SERVICE PLAN | 3,845 | $357K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,593 | $2.6M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,593 | $2.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,593 | $2.6M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,593 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,593 | — |
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.