| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 70 LINDEN OAKS, SUITE 210 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $118K | $0 | $118K | 4.48% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 70 LINDEN OAKS, SUITE 210 ROCHESTER, NY 14625 | DELTA DENTAL OF NEW YORK | $4K | $0 | $4K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $2K | $617 | $3K | 5.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | $0 | $1K | 9.23% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $974 | $0 | $974 | 6.71% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | ALLSTATE LIFE INSURANCE COMPANY OF NEW YORK | $129 | $0 | $129 | 0.89% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | $161 | $24 | $185 | 12.04% |
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 | 360 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 220 | $2.6M |
| Dental | DELTA DENTAL OF NEW YORK | 255 | $71K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 207 | $15K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 360 | $50K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 360 | $50K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 360 | $50K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 220 | $2.6M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 360 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 360 | — |
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.