| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFIT LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF INDIANA | $2K | — | $2K | 2.60% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - IND | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $713 | $446 | $1K | 3.25% |
| VHA CENTRAL INSURANCE SERVICES3 | 8900 KEYSTONE CROSSING STE 480 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $356 | — | $356 | 1.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE ON BEHALF OF COMBINED INSURANCE COMPANY OF AMERICA | $198 | — | $198 | 5.77% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | PO BOX 310502 DES MOINES, IA 50331 | HYATT LEGAL PLANS, INC. | $106 | — | $106 | 5.14% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HYATT LEGAL PLANS, INC. | $30 | $11 | $41 | 1.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA, INC. | 111 MONUMENT CIRCLE #4300 INDIANAPOLIS, IN 46204 | FEDERAL INSURANCE COMPANY | $108 | — | $108 | 20.04% |
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 | 216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 163 | $71K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 80 | $19K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 226 | $36K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 226 | $36K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 226 | $36K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 226 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.