| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 27647 NETWORK PLACE CHICAGO, IL 60673 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $21K | — | $21K | 0.85% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 155 N WACKER DRIVE SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $24K | $1K | $25K | 2.19% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $4K | — | $4K | 5.79% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $4K | — | $4K | 9.97% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $1K | — | $1K | 4.96% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $1K | — | $1K | 12.49% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO. OF NEW YORK | -$24 | — | -$24 | — |
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 | 195 | 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) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 208 | $3.7M |
| Dental | DELTA DENTAL OF NEW YORK | 189 | $274K |
| Vision | VISION SERVICE PLAN | 109 | $26K |
| Life insurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 189 | $72K |
| Short-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 5 | $0 |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 189 | $45K |
| Prescription drug(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 208 | $3.7M |
| Other | CIGNA LIFE INSURANCE CO. OF NEW YORK | 189 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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.