| 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 | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $50K | — | $50K | 1.18% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $8K | — | $8K | 5.68% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $9K | — | $9K | 8.69% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $7K | — | $7K | 8.66% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $260 | — | $260 | 5.67% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $148 | — | $148 | 8.65% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $421 | — | $421 | 25.53% |
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 | 391 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 398 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 702 | $4.2M |
| Life insurance(3 contracts) | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 393 | $140K |
| Short-term disability(2 contracts) | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 174 | $86K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 379 | $98K |
| Prescription drug | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 702 | $4.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 702 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.