| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $127 | $127 | 0.08% |
| ASSUREDPARTNERS3 Filed as: ASSURED NL INSURANCE AGENCY, INC. | 2305 RIVER ROAD, SUITE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 4.36% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $254 | — | $254 | 0.52% |
| ASSUREDPARTNERS3 Filed as: ASSURED NL INSURANCE AGENCY, INC. | 2305 RIVER ROAD, SUITE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 3.98% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $250 | — | $250 | 0.79% |
| ASSUREDPARTNERS3 Filed as: ASSURED NL INSURANCE AGENCY, INC. | 2305 RIVER ROAD, SUITE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 4.63% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $168 | — | $168 | 0.54% |
| ASSUREDPARTNERS3 Filed as: ASSURED NL INSURANCE AGENCY, INC. | 2305 RIVER ROAD, SUITE 300 LOUISVILLE, KY 40206 | VISION SERVICE PLAN | $640 | — | $640 | 3.61% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $386 | — | $386 | 2.18% |
| ASSUREDPARTNERS3 Filed as: ASSURED NL INSURANCE AGENCY, INC. | 2305 RIVER ROAD, SUITE 300 LOUISVILLE, KY 40206 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $386 | — | $386 | 6.47% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $35 | — | $35 | 0.59% |
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 | 450 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 456 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 13 | $65K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 372 | $221K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 140 | $83K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 450 | $49K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 450 | $31K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 450 | $31K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 450 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 450 | — |
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.