| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | RELIASTAR LIFE INSURANCE COMPANY | $188K | — | $188K | 11.40% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740045 | RELIASTAR LIFE INSURANCE COMPANY | — | $13K | $13K | 0.80% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IA 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $7K | $7K | 1.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALHT & BENEFITS LLC | PO BOX 310502 DES MOINES, IA 50331 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 11.95% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | PO BOX 850502 MINNEAPOLIS, MN 554850502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $95 | $3K | 11.61% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $286 | — | $286 | 1.16% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | ARAG INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | PO BOX 850502 MINNEAPOLIS, MN 554850502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $30 | $2K | 14.08% |
| BENEFITSTORE INC8 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $148 | — | $148 | 1.23% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 850502 MINNEAPOLIS, MN 554850502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $101 | $6 | $107 | 3.36% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $58 | — | $58 | 1.82% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | PO BOX 850502 MINNEAPOLIS, MN 554850502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $736 | $8 | $744 | 25.64% |
| BENEFITSTORE INC3 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $71 | — | $71 | 2.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD EIN 57-0287419 NONE | Claims processing; Other services Service code 12 | — | $269K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Contract Administrator Service code 13 | — | $74K |
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 | 430 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 53 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 483 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 8 | $89K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 933 | $557K |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 282 | $149K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 547 | $435K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 547 | $435K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 8 | $89K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 1,072 | $1.6M |
| Other(8 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 547 | $528K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,072 | — |
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.