| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AETNA HEALTH, INC. | $82K | $0 | $82K | 2.95% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA HEALTH, INC. | $28K | $0 | $28K | 1.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AETNA LIFE INSURANCE COMPANY | $19K | $19 | $19K | 4.50% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 1.53% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN ANAHEIM HILLS, CA 92808 | AETNA LIFE INSURANCE COMPANY | $0 | $48 | $48 | 0.01% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | $0 | $15K | 10.17% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, VA 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | $0 | $15K | 10.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 0.81% |
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 | 310 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 495 | $3.2M |
| Dental | AETNA LIFE INSURANCE COMPANY | 495 | $428K |
| Vision | AETNA LIFE INSURANCE COMPANY | 495 | $428K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 310 | $146K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 310 | $146K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 310 | $146K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 495 | $3.2M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 310 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 495 | — |
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.