| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC5 Filed as: MARSH USA, INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 100362774 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $364K | $364K | 2.83% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $216K | — | $216K | 1.68% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $207K | — | $207K | 1.61% |
| LOCKTON COMPANIES, LLC3 | 4725 PIEDMONT ROW DRIVE CHARLOTTE, NC 28210 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $57K | — | $57K | 0.96% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE COMPANY | $58K | — | $58K | 5.07% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $27K | — | $27K | 3.00% |
| USI INSURANCE SERVICES LLC7 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | — | $19K | 3.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD ACCIDENT AND LIFE INSURANCE COMPANY | $26K | — | $26K | 5.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA US HEALTH CARE EIN 06-6033492 CONTRACT ADMINISTRATION | Contract Administrator; Direct payment from the plan Service code 13 | — | $7.0M |
| EXPRESS SCRIPTS EIN 22-3461740 CLAIMS PROCESSING | Claims processing Service code 12 | — | $1.6M |
| VIRGIN PULSE EIN 20-2547480 CONSULTANT | Claims processing Service code 12 | — | $999K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 CLAIMS ADMIN | Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | — | $571K |
| RX SAVINGS SOLUTIONS EIN 26-3642434 CONSULTANT | Contract Administrator Service code 13 | — | $426K |
| HEADSPACE CONSULTANT | Contract Administrator Service code 13 | 2415 MICHIGAN AVENUE SANTA MONICA, CA 90404 | $214K |
| WAGEWORKS, INC. EIN 20-0198855 COBRA ADMINSTRATION | Direct payment from the plan; Claims processing Service code 12 | — | $210K |
| MERCER EIN 34-2015463 CONSULTANT | Direct payment from the plan; Participant communication; Contract Administrator Service code 13 | — | $136K |
| BUDCO EIN 38-1622051 CONSULTANT | Claims processing Service code 12 | — | $119K |
| ELLIOTT DAVIS, LLC EIN 57-0381582 ACCOUNTING | Direct payment from the plan; Consulting fees Service code 50 | — | $72K |
| BRIAN S. KING, P.C. EIN 47-4929924 SETTLEMENT AGREEMENT | Other services Service code 49 | — | $30K |
| SAN FRANCISCO CITY OPTION OTHER | Other fees Service code 99 | P.O. BOX 194367 SAN FRANCISCO, CA 94119 | $15K |
| US BANK NATIONAL ASSOCIATION EIN 31-0841368 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $8K |
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 | 31,564 | 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) | 31,564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 763 | $5.9M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 4,581 | $7.0M |
| Life insurance(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 55,238 | $19.1M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 330 | $105K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 12,153 | $5.6M |
| Other(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 32,295 | $7.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 55,238 | — |
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.