| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TOLMAN & WIKER3 Filed as: TOLMAN & WIKER INSURANCE | SERVICES LLC P.O. BOX 1388 VENTURA, CA 93002 | BLUE CROSS OF CALIFORNIA | $231K | — | $231K | 3.60% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | INC. P.O. BOX 39000 SAN FRANCISCO, CA 94139 | BLUE CROSS OF CALIFORNIA | — | $8K | $8K | 0.13% |
| THE FARMINGTON COMPANY3 | 30 WATERSIDE DR. P.O. BOX 527 FARMINGTON, CT 06034 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $1K | $12K | 15.15% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $204 | $5K | 5.98% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | P.O. BOX 905494 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| THE FARMINGTON COMPANY3 | 30 WATERSIDE DRIVE P.O. BOX 527 FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $837 | $9K | 12.15% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $153 | $3K | 4.93% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $571 | $7K | 16.25% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 11.78% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY | 1820 EAST FIRST STREET SUITE 400 SANTA ANA, CA 92705 | TRANSAMERICA LIFE INSURANCE COMPANY | $303 | — | $303 | 0.90% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 12421 MEREDITH DRIVE URBANDALE, IA 50398 | TRANSAMERICA LIFE INSURANCE COMPANY | $189 | — | $189 | 0.56% |
| CESAR V. GOLDMAN3 | 23680 PARK SEVILLA CALABASAS, CA 91302 | TRANSAMERICA LIFE INSURANCE COMPANY | $169 | — | $169 | 0.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SEABURY & SMITH INC. | P.O. BOX 9282 DES MOINES, IA 50306 | TRANSAMERICA LIFE INSURANCE COMPANY | $157 | — | $157 | 0.46% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | TRANSAMERICA LIFE INSURANCE COMPANY | $93 | — | $93 | 0.28% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 14.64% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HYATT LEGAL PLANS | $1K | $238 | $1K | 10.79% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 1820 EAST FIRST STREET SANTA ANA, CA 92705 | UNION SECURITY LIFE INSURANCE COMPANY | $740 | — | $740 | 8.00% |
| DISABILITY RMS3 Filed as: DISABILITY RMS, INC. | 300 SOUTHBOROUGH DRIVE SUITE 200 SOUTH PORTLAND, ME 04106 | UNION SECURITY LIFE INSURANCE COMPANY | — | $398 | $398 | 4.30% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | UNION SECURITY LIFE INSURANCE COMPANY | $246 | — | $246 | 2.66% |
| JAMES QUINNEY3 | 3031 STANFORD RANCH ROAD ROCKLIN, CA 95765 | UNION SECURITY LIFE INSURANCE COMPANY | $197 | — | $197 | 2.13% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | P.O. BOX 905494 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $99 | — | $99 | 2.50% |
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 | 840 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 858 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 1,061 | $6.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 1,061 | $6.4M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 849 | $42K |
| Life insurance(6 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 1,061 | $6.6M |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 164 | $89K |
| Other(6 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 1,061 | $6.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,061 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.