| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SUMITOMO LIFE INSURANCE AGENCY3 Filed as: SUMITOMO LIFE INSURANCE | 565 FIFTH AVENUE 5TH FLOOR NEW YORK, NY 10017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $2K | $6K | 9.44% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 3.06% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH JCS INC | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 11.69% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $17 | $4K | 9.75% |
| SUMITOMO LIFE INSURANCE AGENCY3 Filed as: SUMITOMO LIFE INSURANCE | 565 FIFTH AVENUE 5TH FLOOR NEW YORK, NY 10017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $132 | $1K | 7.33% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $642 | — | $642 | 3.37% |
| SUMITOMO LIFE INSURANCE AGENCY3 Filed as: SUMITOMO LIFE INSURANCE | 565 FIFTH AVENUE 5TH FLOOR NEW YORK, NY 10017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $465 | $193 | $658 | 9.44% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $231 | — | $231 | 3.32% |
| SUMITOMO LIFE INSURANCE AGENCY3 Filed as: SUMITOMO LIFE INSURANCE | 565 FIFTH AVENUE 5TH FLOOR NEW YORK, NY 10017 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $329 | $512 | $841 | 16.93% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHCIAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $167 | — | $167 | 3.36% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $17 | $17 | — |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $146 | $146 | — |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $48 | $48 | — |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $13 | $13 | — |
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 |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $38K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $38K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 223 | $63K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $5K |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $19K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 223 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.