| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5482 WILSHIRE BLVD STE 1566 LOS ANGELES, CA 90036 | HARTFORD LIFE AND ACCIDENT | $85K | $46K | $131K | 11.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $7K | $7K | 5.45% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.59% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $70 | $70 | 0.05% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5482 WILSHIRE BLVD STE 1566 LOS ANGELES, CA 90036 | HARTFORD LIFE AND ACCIDENT | $6K | $4K | $9K | 8.29% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 9.62% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $907 | $907 | 1.83% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $70 | $70 | 0.14% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5482 WILSHIRE BLVD STE 1566 LOS ANGELES, CA 90036 | HARTFORD LIFE AND ACCIDENT | $771 | $230 | $1K | 19.46% |
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 | 1,626 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 200 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,826 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 2,600 | $24.1M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 4,019 | $1.9M |
| Vision | VISION SERVICE PLAN | 2,104 | $335K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,847 | $1.2M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,847 | $1.2M |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 2,600 | $24.1M |
| Other(6 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 3,162 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,019 | — |
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.