| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 155 N WACKER DR STE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN, INC. | $13K | — | $13K | 0.78% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | — | $6K | 0.38% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $10K | — | $10K | 8.29% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 8.41% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $440 | — | $440 | 0.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $12 | — | $12 | 0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4695 MCARTHUR COURT SUITE 700 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $172 | — | $172 | 0.39% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | PO BOX 850502 MINNEAPOLIS, MN 554850001 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | — | $10K | 36.37% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 8.15% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | PO BOX 850502 MINNEAPOLIS, MN 554850001 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 25.72% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | PO BOX 850502 MINNEAPOLIS, MN 554850001 | METROPOLITAN LIFE INSURANCE COMPANY | -$53K | — | -$53K | -225.64% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $697 | — | $697 | 8.37% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $529 | — | $529 | 8.32% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | METROPOLITAN GENERAL INSURANCE COMPANY | $760 | — | $760 | 14.19% |
| PAYLOGIX3 Filed as: PAYLOGIX LLC | 1025 OLD COUNTRY RD, SUITE 310 WESTBURY, NY 11590 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $277 | $277 | 5.17% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | METLIFE LEGAL PLANS | $340 | — | $340 | 7.23% |
| PAYLOGIX3 Filed as: PAYLOGIX LLC | 1025 OLD COUNTRY RD, SUITE 310 WESTBURY, NY 11590 | METLIFE LEGAL PLANS | — | $242 | $242 | 5.14% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | METLIFE LEGAL PLANS | — | $29 | $29 | 0.62% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $23 | — | $23 | 0.83% |
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 | 1,752 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,757 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 512 | $2.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 289 | $24K |
| Vision | VISION SERVICE PLAN | 862 | $44K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,555 | $125K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 44 | $27K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,306 | $66K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 369 | $2.1M |
| Other(8 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,555 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,555 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.