| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740000 | BLUE CROSS BLUE SHIELD | $35K | $1K | $36K | 1.91% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 125 OTTAWA AVENUE NW SUITE 400 CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | $970 | $7K | 5.60% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD SUITE 100 CARMEL, IN 46032 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.94% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DEARBORN NATIONAL | $7K | — | $7K | 9.29% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE | 111 CONGRESSIONAL BLVD CARMEL, IN 46032 | DEARBORN NATIONAL | $1K | — | $1K | 1.66% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD SUITE 100 CARMEL, IN 460325643 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 10.07% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740000 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 8.46% |
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 | 322 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 322 | $1.9M |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 270 | $23K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 190 | $199K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 190 | $124K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 190 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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.