| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 891016023 | KAISER FOUNDATION HEALTH PLAN INC. | $35K | $0 | $35K | 2.75% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANT | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $25K | $0 | $25K | 4.67% |
| 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 | 0.33% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANT | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $0 | $20K | 4.70% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 0.29% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANT | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | $0 | $19K | 4.70% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 0.30% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 891016023 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | $0 | $10K | 2.69% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | $2K | $26K | 19.39% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 SOUTH 4TH STREET SUITE 704 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $1K | $16K | 19.92% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 SOUTH 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 4.71% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $192 | $0 | $192 | 0.29% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S. 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | HYATT LEGAL PLANS | $2K | $0 | $2K | 14.41% |
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 | 3,764 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,790 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,328 | $1.9M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,662 | $425K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 638 | $534K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,722 | $405K |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,662 | $590K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,722 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.