| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRLCE CHICAGO, IL 60674 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $8K | $8K | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | MONUMENTAL LIFE INSURANCE COMPANY | — | $2K | $2K | 8.11% |
| N/A3 | — | ACE AMERICAN INSURANCE COMPANY | — | $5K | $5K | 20.00% |
| N/A3 | — | ACE AMERICAN INSURANCE COMPANY | — | $3K | $3K | 20.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | SAFEGUARD HEALTH PLANS, INC. | — | $60 | $60 | 0.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 | Claims processing; Contract Administrator Service code 12 | — | $155K |
| THE HARTFORD EIN 06-0838648 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | P.O. BOX 2999 HARTFORD, CT 06104 | $83K |
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 THIRD PARTY ADMINISTRATOR | Float revenue; Other fees; Direct payment from the plan; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services; Claims processing Service code 12 | — | $9K |
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 | 3,728 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 70 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 1 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 3,799 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 4,620 | $25.8M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 767 | $356K |
| Vision | HM LIFE INSURANCE COMPANY | 5,407 | $311K |
| Life insurance(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 2,982 | $6.7M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,982 | $3.0M |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF ILLINOIS | 4,620 | $22.2M |
| Other(7 contracts, 6 carriers) | AETNA LIFE INSURANCE COMPANY | 4,000 | $6.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,407 | — |
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.