| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | WASHINGTON SQUARE 1050 CONNECTICUIT AVE WASHINGTON, DC 20036 | DELTA DENTAL OF MASSACHUSETTS, INC. D/B/A/ DELTA DENTAL OF MA | $300 | $0 | $300 | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - BOSTON | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 1.45% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - BOSTON | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $2K | $19K | 7.52% |
| THE FARMINGTON COMPANY3 Filed as: THE FARMINGTON INSURANCE AGENCY INC | PO BOX 665 99 FOX HILL DR HOLDEN, MA 01520 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $647 | — | $647 | 0.26% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - BOSTON | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $1K | $13K | 13.44% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - BOSTON | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $539 | $7K | 7.55% |
| THE FARMINGTON COMPANY3 Filed as: THE FARMINGTON INSURANCE AGENCY INC | 30 WATERSIDE DRIVE FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | -$208 | $3K | 3.73% |
| THE FARMINGTON COMPANY3 | 30 WATERSIDE DRIVE FARMINGTON, CT 06034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2 | $2 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - BOSTON | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE | $2K | $0 | $2K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - BOSTON | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $562 | $5K | 13.83% |
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 | 750 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 777 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MASSACHUSETTS, INC. D/B/A/ DELTA DENTAL OF MA | 1,905 | $820K |
| Vision | EYEMED VISION CARE | 1,080 | $48K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 747 | $365K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 747 | $300K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 747 | $705K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,905 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.