| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 155 N. WACKER DRIVE SUITE 1500 CHICAGO, IL 606061710 | KAISER FOUNDATION HEALTH PLAN INC. | $54K | — | $54K | 2.67% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $695 | — | $695 | 0.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $565 | — | $565 | 0.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $439 | — | $439 | 0.52% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $256 | — | $256 | 0.46% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | ADMINISTRATION LLC 4565 PAYSHPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $100 | — | $100 | 0.56% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH ANDBENEFITS | ADMINISTRATION LLC 4565 PAYSHPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METLIFE LEGAL PLANS | $887 | $258 | $1K | 10.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METLIFE LEGAL PLANS | $238 | — | $238 | 2.12% |
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 | 1,215 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 449 | $2.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 292 | $50K |
| Vision | VISION SERVICE PLAN | 690 | $90K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,187 | $178K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,215 | $93K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,212 | $100K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 449 | $2.0M |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,192 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,215 | — |
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.