| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CONNECTICUT GENERAL AND LIFE INSURANCE CO. & AFFILIATES | $63K | — | $63K | 9.63% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $926 | — | $926 | 12.64% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $170 | — | $170 | 15.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONNECTICUT GENERAL LIFE INS CO EIN 59-1031071 CLAIM ADMINISTRATION | Non-monetary compensation; Other services; Float revenue; Participant communication; Contract Administrator; Direct payment from the plan; Named fiduciary; Claims processing Service code 12 | A CIGNA COMPANY HARTFORD, CT 06152 | $174K |
| DELTA DENTAL PLAN OF NEW HAMPSHIRE EIN 02-0273013 DENTAL CLAIMS PROCESSING | Claims processing Service code 12 | ONE DELTA DRIVE CONCORD, NH 03302 | $13K |
| MKS PERFORMANCE SOLUTIONS, LLC EIN 32-0209348 CLAIM ADMINISTRATION | Contract Administrator; Participant communication; Direct payment from the plan Service code 13 | 18 NORTH MAIN STREET CONCORD, NH 03301 | $10K |
| CIGNA EIN 41-1648670 CLAIM ADMINISTRATION | Participant communication; Float revenue; Named fiduciary; Contract Administrator; Non-monetary compensation; Claims processing; Other services; Direct payment from the plan Service code 12 | A CIGNA COMPANY HARTFORD, CT 06152 | $0 |
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 | 302 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | CONNECTICUT GENERAL AND LIFE INSURANCE CO. & AFFILIATES | 382 | $651K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 302 | $7K |
| Stop-loss / reinsurancereinsurance | CONNECTICUT GENERAL AND LIFE INSURANCE CO. & AFFILIATES | 382 | $651K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 302 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 382 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.