| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 11036 | WELLPOINT STOP LOSS | $2K | $1K | $4K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE DBA ANTHEM EIN 31-1440175 NONE | Other services; Float revenue; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $178K |
| EXTEND HEALTH INC EIN 26-0775680 NONE | Claims processing; Contract Administrator Service code 12 | — | $64K |
| MEADEN & MOORE EIN 34-1818258 NONE | Accounting (including auditing) Service code 10 | — | $39K |
| AMERIBEN EIN 82-0497661 NONE | Claims processing Service code 12 | — | $30K |
| QUANTUM HEALTH INC EIN 20-8423895 NONE | Direct payment from the plan; Participant communication; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $24K |
| CAREMARK PHARMACY INC. EIN 05-0340626 NONE | Contract Administrator; Claims processing Service code 12 | — | $19K |
| MERCER EIN 13-2834414 NONE | Actuarial Service code 11 | — | $17K |
| NORTHERN TRUST CORPORATION EIN 36-2723087 NONE | Custodial (securities) Service code 19 | — | $900 |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 225 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | WELLPOINT STOP LOSS | 1,011 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,011 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.