| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH & LIFE INSURANCE COMPANY (CIGNA) | $68K | — | $68K | 9.88% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | SUN LIFE ASSURANCE COMPANY OF CANADA | $105 | — | $105 | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED HEALTHCARE INSURANCE COMPANY - PDP PLAN | $5K | — | $5K | 2.65% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED HEALTHCARE INSURANCE COMPANY - MA (HEALTH) | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 PROVIDES CLAIM ADM & SERV | Non-monetary compensation; Other services; Float revenue; Participant communication; Contract Administrator; Direct payment from the plan; Named fiduciary; Claims processing Service code 12 | 900 COTTAGE GROVE ROAD HARTFORD, CT 06152 | $385K |
| SEI PRIVATE TRUST COMPANY EIN 23-3060382 | Claims processing; Trustee (bank, trust company, or similar financial institution) Service code 12 | PO BOX 1100 OAKS, PA 19456 | $53K |
| SUN LIFE ASSURANCE COMPANY OF CANAD EIN 38-1082080 | Insurance agents and brokers Service code 22 | ONE SUN LIFE EXECUTIVE PARK WELLESLEY HILLS, MA 024815699 | $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 | 249 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 232 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 481 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY - AARP MEDICARE SUPPLEMENTAL | 143 | $738K |
| Dental | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | 24 | $222K |
| Vision(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | 274 | $244K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 320 | $240K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 320 | $240K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 320 | $240K |
| Prescription drug(3 contracts, 3 carriers) | CVS HEALTH/CVS PHARMACY INC | 274 | $1.5M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH & LIFE INSURANCE COMPANY (CIGNA) | 274 | $686K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.