| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA-CIGNA | $2K | — | $2K | 2.64% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PL CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA-CIGNA | $2K | — | $2K | 1.65% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | PO BOX 905494 CHARLOTTE, NC 28290 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $234 | — | $234 | 0.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4 EMBARCADERO CENTER STE 400 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $76 | — | $76 | 0.18% |
| REUBEN WARNER ASSOCIATES, INC.4 | 1655 RICHMOND AVE. STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | — | $321 | $321 | 15.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 1050 CONNECTICUT AVE. NW STE 700 WASHINGTON, DC 20036 | ZURICH AMERICAN INSURANCE COMPANY | $88 | — | $88 | 4.11% |
| AON CONSULTING INC3 Filed as: AON | 20TH STREET, NW WASHINGTON, DC 20036 | ZURICH AMERICAN INSURANCE COMPANY | $19 | — | $19 | 0.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357120 CLAIMS ADMINISTRATION | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other services; Other fees; Contract Administrator Service code 12 | — | $150K |
| NETWORK ADMINISTRATORS DBA GSA EIN 11-3335620 ADMIN SUPPORT SERVICES | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 15 | — | $93K |
| FRYE & COMPANY CPAS EIN 45-4199441 AUDITOR | Accounting (including auditing) Service code 10 | — | $21K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 CLAIMS ADMINISTRATION | Claims processing; Contract Administrator Service code 12 | — | $16K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 CLAIMS ADMINISTRATION | Claims processing Service code 12 | — | $8K |
| MERCER HEALTH AND BENEFITS LLC | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $2K |
| AON CONSULTING, INC. | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $934 |
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 | 416 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 5 | $41K |
| Dental | DELTA DENTAL OF VIRGINIA | 573 | $171K |
| Vision | VISION SERVICE PLAN | 263 | $70K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA-CIGNA | 370 | $93K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA-CIGNA | 370 | $3K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA-CIGNA | 370 | $55K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 223 | $67K |
| Other | ZURICH AMERICAN INSURANCE COMPANY | 162 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 573 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.