| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUTH LARKIN3 | 167 N GREEN ST., 4TH FLOOR CHICAGO, IL 60622 | COMBINED INSURANCE | $189K | — | $189K | 12.19% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & COMPANY | 50 CALIFORNIA STREET FLOOR 12 SAN FRANCISCO, CA 94111 | COMBINED INSURANCE | $23K | — | $23K | 1.49% |
| J MANNING AND ASSOCIATES3 | 220 N SOUTH GREEN ST. CHICAGO, IL 60607 | COMBINED INSURANCE | $15K | — | $15K | 0.99% |
| LTCI PARTNERS LLC3 | 14546 BROOK HOLLOW BLVD #281 SAN ANTONIO, TX 78232 | COMBINED INSURANCE | $15K | — | $15K | 0.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | FOUR EVER LIFE INS CO. | $43K | — | $43K | 8.24% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,505 | $10.6M |
| Dental | FOUR EVER LIFE INS CO. | 63 | $519K |
| Vision | FOUR EVER LIFE INS CO. | 63 | $519K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $9.3M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $3.3M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,505 | $10.1M |
| Other(4 contracts, 4 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 13,275 | $5.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,275 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.