| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 27647 NETWORK PLACE CHICAGO, IL 60673 | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS BLUE SHIELD | $8K | — | $8K | 0.88% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 6.48% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 27647 NETWORK PLACE CHICAGO, IL 60673 | ANTHEM LIFE INSURANCE COMPANY | $692 | — | $692 | 2.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 INSURANCE PROVIDER | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $521K |
| MERCER HEALTH & BENEFITS EIN 34-2015463 INSURANCE PROVIDER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | — | $57K |
| WILLIS INSURANCE SERVICES OF CA | Non-monetary compensation; Other commissions; Insurance agents and brokers Service code 22 | — | $673 |
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 | 552 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 552 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS BLUE SHIELD | 429 | $900K |
| Vision | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS BLUE SHIELD | 429 | $900K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 552 | $31K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY DBA ANTHEM BLUE CROSS BLUE SHIELD | 429 | $900K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 552 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 552 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.