| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC7 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $93K | $41K | $134K | 7.92% |
| MERCER HEALTH AND BENEFITS, LLC7 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $88K | $65K | $153K | 9.53% |
| MERCER HEALTH AND BENEFITS, LLC7 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $61K | $33K | $94K | 7.00% |
| MERCER HEALTH AND BENEFITS, LLC7 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $3K | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK BLUE SHIELD EIN 23-1294723 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | P.O. BOX 890173 CAMP HILL, PA 17089 | $3.1M |
| DELTA DENTAL OF PENNSLVANIA EIN 23-1667011 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | ONE DELTA DRIVE MECHANICSBURG, PA 17055 | $206K |
| AMERIFLEX, LLC EIN 22-3639401 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 2508 HIGHLANDER WAY SUITE 200 CARROLLTON, TX 75006 | $72K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | P.O. BOX 997330 SACRAMENTO, CA 95899 | $55K |
| DAVIS VISION EIN 11-3051991 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | 175 E HOUSTON STREET 5TH FLOOR SAN ANTONIO, TX 78205 | $24K |
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 | 6,817 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,819 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 5,449 | $1.7M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,976 | $1.6M |
| Other(2 contracts) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 5,339 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,449 | — |
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.