| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $2K | $20K | 1.48% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $9K | $18K | 2.65% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COMBINED INSURANCE CO. OF AMERICA | $25K | — | $25K | 5.42% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $11K | — | $11K | 5.31% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | ACE AMERICAN INSURANCE COMPANY | $14K | — | $14K | 15.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COMBINED INSURANCE CO. OF AMERICA | $81 | — | $81 | 6.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF KY, INC EIN 61-1237516 N/A | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services Service code 12 | — | $1.3M |
| UNUM LIFE INSURANCE CO. OF AMERICA EIN 01-0278678 N/A | Claims processing Service code 12 | — | $32K |
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 | 2,792 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1,903 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,710 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 19 | $200K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF KENTUCKY | 9,944 | $3.5M |
| Vision(3 contracts, 2 carriers) | COMBINED INSURANCE CO. OF AMERICA | 8,157 | $659K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 7,094 | $1.4M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,732 | $697K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 12,700 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,700 | — |
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.