| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $27K | — | $27K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | — | $21K | 9.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | P O BOX 310502 DES MOINES, IA 503310502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | $430 | $6K | 13.55% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN | P O BOX 310502 DES MOINES, IA 50331 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 15.83% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 19.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | CONCOURSE CORPORATE CTR 5 18TH FL ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $415 | — | $415 | 1.48% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES,LLC-HOUSTON SERIE | DEPT 3042 PO BOX 123042 DALLAS, TX 75312 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.17% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $561 | — | $561 | 5.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | CONCOURSE CORPORATE CTR 5 18TH FL ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.45% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | P O BOX 310502 DES MOINES, IA 503310502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $94 | $1K | 18.58% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | P O BOX 310502 DES MOINES, IA 503310502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $428 | $33 | $461 | 15.38% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $152 | — | $152 | 7.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 18TH FL CONCOURSE CORPORATE CTR 5 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 2.26% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | P O BOX 310502 DES MOINES, IA 503310502 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $31 | $5 | $36 | 8.89% |
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 | 782 | 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) | 790 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 89 | $34K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 600 | $129K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 782 | $207K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 782 | $268K |
| Other(10 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 782 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 782 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.