| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 155 N WACKER DRIVE SUITE 1500 CHICAGO, IL 606061710 | BLUE CROSS BLUE SHEILD OF ILLINOIS | $167K | $5K | $172K | 1.46% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $84K | — | $84K | 13.15% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $354 | $354 | 0.06% |
| ROBERT K PADGETT3 Filed as: ROBERT K. PADGETT | PO BOX 12235 SCOTTSDALE, AZ 852672235 | VISION SERVICE PLAN | $3K | — | $3K | 1.38% |
| MARY CLISTA HUTZ3 | PO BOX 5481 CAREFREE, AZ 853775481 | VISION SERVICE PLAN | $880 | — | $880 | 0.46% |
| ROBERT K PADGETT3 Filed as: ROBERT PADGETT | PO BOX 12235 SCOTTSDALE, AZ 853672235 | DELTA DENTAL OF ILLINOIS | $8K | — | $8K | 27.97% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC | 353 NORTH CLARK STREET CHICAGO, IL 60654 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $4K | — | $4K | 15.00% |
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 | 1,408 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,423 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHEILD OF ILLINOIS | 1,882 | $11.8M |
| Dental | DELTA DENTAL OF ILLINOIS | 918 | $30K |
| Vision | VISION SERVICE PLAN | 908 | $192K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,092 | $639K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,092 | $639K |
| Prescription drug | BLUE CROSS BLUE SHEILD OF ILLINOIS | 1,882 | $11.8M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHEILD OF ILLINOIS | 1,882 | $11.8M |
| Other(3 contracts, 3 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,408 | $695K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,882 | — |
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.