| 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 | $98K | — | $98K | 5.63% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740045 | RELIASTAR LIFE INSURANCE COMPANY | — | $14K | $14K | 0.80% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IA 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 1.84% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $100 | $100 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | PO BOX 850502 MINNEAPOLIS, MN 554850502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | $473 | $7K | 20.83% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $149 | — | $149 | 0.44% |
| 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 | 12.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | ARAG INSURANCE COMPANY | $2K | — | $2K | 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 | $1K | $152 | $1K | 12.54% |
| BENEFITSTORE INC8 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $64 | — | $64 | 0.66% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | PO BOX 850502 MINNEAPOLIS, MN 554850502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $678 | $143 | $821 | 13.68% |
| BENEFITSTORE INC3 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $25 | — | $25 | 0.42% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 850502 MINNEAPOLIS, MN 554850502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $445 | $38 | $483 | 16.93% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $39 | — | $39 | 1.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD EIN 59-2015694 NONE | Other services; Claims processing Service code 12 | — | $296K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Contract Administrator Service code 13 | — | $171K |
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 | 42 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 118 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | AETNA LIFE INSURANCE COMPANY | 2 | $40K |
| Dental(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 978 | $526K |
| Vision(3 contracts, 2 carriers) | VISION SERVICE PLAN | 321 | $105K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 563 | $468K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 563 | $468K |
| Prescription drug(2 contracts) | AETNA LIFE INSURANCE COMPANY | 2 | $40K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 1,108 | $1.7M |
| Other(8 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 563 | $570K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,108 | — |
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."
No prospect flags tripped on this filing.