| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $39K | $16K | $55K | 8.06% |
| STAHL & ASSOCIATES INSURANCE INC.3 Filed as: STAHL & ASSOCIATES INSURANCE | 91 LAKE MORTON DRIVE LAKELAND, FL 33801 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $15K | — | $15K | 2.14% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $16K | $6K | $21K | 8.50% |
| STAHL & ASSOCIATES INSURANCE INC.3 Filed as: STAHL & ASSOCIATES INSURANCE | 91 LAKE MORTON DR LAKELAND, FL 33801 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $4K | — | $4K | 1.55% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $2K | $15K | 13.06% |
| STAHL & ASSOCIATES INSURANCE INC.3 Filed as: STAHL & ASSOC INS INC | 110 CARILLON PKWY ST PETERSBURG, FL 337161201 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 3.84% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $483 | $10K | 15.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 HLTH ASO PROVIDER | Insurance agents and brokers; Float revenue; Other commissions; Claims processing; Insurance brokerage commissions and fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $1.2M |
| LIBERTY LIFE ASSURANCE COMPANY OF EIN 04-6076039 FMLA ASO ADMINISTRATOR | Other services; Participant communication; Contract Administrator Service code 13 | — | $80K |
| LIBERTY MUTUAL ASSURANCE COMPANY OF EIN 04-6076039 STD ASO ADMINISTRATOR | Direct payment from the plan; Other services; Contract Administrator; Participant communication; Claims processing Service code 12 | — | $68K |
| BENSINGER DUPONT & ASSOCIATES EIN 36-3185080 EAP ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Claims processing; Contract Administrator Service code 12 | 134 NORTH LASALLE STREET CHICAGO, IL 60602 | $26K |
| MERCER HEALTH & BENEFITS FMLA ASO BROKER | Other commissions Service code 55 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | $6K |
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 | 1,645 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 85 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,730 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,115 | $115K |
| Vision | VISION SERVICE PLAN | 1,505 | $252K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,140 | $679K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,640 | $251K |
| Other(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,525 | $745K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,525 | — |
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.