| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | — | THE HARTFORD LIFE INSURANCE COMPANY | $0 | $54 | $54 | 1.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BANK OF NEW YORK EIN 13-5160382 CUSTODIAN | Custodial (securities); Investment management; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 19 | — | $53K |
| PRICEWATERHOUSECOOPERS LLP EIN 13-4008324 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $50K |
| KPMG EIN 46-1025091 NONE | Accounting (including auditing) Service code 10 | — | $23K |
| MERCER EIN 34-2015463 NONE | Consulting (general) Service code 16 | — | $22K |
| GLOBAL MULTI-ASSET FUND EIN 46-1025091 NONE | Direct payment from the plan; Investment management Service code 28 | — | $14K |
| EMPIRE BLUE CROSS BLUE SHIELD EIN 23-7391136 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $9K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 303 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE MEDIBLUE FREEDOM PPO | 96 | $160K |
| Life insurance | THE HARTFORD LIFE INSURANCE COMPANY | 347 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 347 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.