| 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 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $3K | $8K | 8.90% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $1K | — | $1K | 1.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | -$7K | — | -$7K | -17.27% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVE STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | — | $219 | $219 | 14.94% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 1050 CONNECTICUT AVE. NW STE 700 WASHINGTON, DC 20036 | ZURICH AMERICAN INSURANCE COMPANY | $73 | — | $73 | 4.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357120 CLAIMS ADMINISTRATION | Other fees; Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $233K |
| NETWORK ADMINISTRATORS DBA GSA EIN 11-3335620 ADMIN SUPPORT SERVICES | Consulting (general); Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $64K |
| ARONSON LLC EIN 37-1611326 AUDITOR | Accounting (including auditing) Service code 10 | — | $36K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 CLAIMS ADMINISTRATION | Claims processing; Contract Administrator Service code 12 | — | $14K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 CLAIMS ADMINISTRATION | Claims processing Service code 12 | — | $3K |
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 | 310 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 9 | $69K |
| Dental | DELTA DENTAL OF VIRGINIA | 227 | $198K |
| Vision | VISION SERVICE PLAN | 207 | $43K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 284 | $92K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 284 | $92K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 284 | $92K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 178 | $0 |
| Other | ZURICH AMERICAN INSURANCE COMPANY | 284 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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.