| 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 60674 | CALIFORNIA PHYSICIANS' SERVICE | $960 | $39K | $40K | 4.11% |
| USB HEALTH LLC3 Filed as: USB HEALTH, LLC. | 99 WOOD AVENUE SUITE 501 WOODBRIDGE TOWNSHIP, NJ 08830 | CALIFORNIA PHYSICIANS' SERVICE | $160 | $6K | $6K | 0.66% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 155 NORTH WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | $0 | $12K | 4.37% |
| USB HEALTH LLC3 Filed as: USB HEALTH, LLC. | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | $0 | $2K | 0.72% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 5955 DE SOTO AVENUE SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN, INC. | -$274 | $0 | -$274 | -0.10% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 155 NORTH WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | $0 | $2K | 3.24% |
| USB HEALTH LLC3 Filed as: USB HEALTH, LLC. | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | KAISER FOUNDATION HEALTH PLAN, INC. | $375 | $0 | $375 | 0.71% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 5955 DE SOTO AVENUE SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN, INC. | $287 | $0 | $287 | 0.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF CALIFORNIA | $4K | $0 | $4K | 7.50% |
| USB HEALTH LLC3 Filed as: USB HEALTH, LLC. | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | DELTA DENTAL OF CALIFORNIA | $1K | $0 | $1K | 2.50% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $64 | $2K | 13.30% |
| USB HEALTH LLC3 Filed as: USB HEALTH, LLC. | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $328 | $437 | $765 | 5.02% |
| ARCHON LLC3 Filed as: ARCHON, LLC. | 225 WIRELESS BOULEVARD HAUPPAGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $326 | $326 | 2.14% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 5955 DE SOTO AVENUE SUITE 250 WOODLAND HILLS, CA 91367 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7 | $0 | $7 | 0.05% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $56 | $2K | 13.28% |
| USB HEALTH LLC3 Filed as: USB HEALTH, LLC. | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $294 | $392 | $686 | 5.05% |
| ARCHON LLC3 Filed as: ARCHON, LLC. | 225 WIRELESS BOULEVARD HAUPPAGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $286 | $286 | 2.11% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 5955 DE SOTO AVENUE SUITE 250 WOODLAND HILLS, CA 91367 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $34 | — | $34 | 0.25% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $37 | $1K | 13.31% |
| USB HEALTH LLC3 Filed as: USB HEALTH, LLC. | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $187 | $249 | $436 | 5.04% |
| ARCHON LLC3 Filed as: ARCHON, LLC. | 225 WIRELESS BOULEVARD HAUPPAGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $184 | $184 | 2.13% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 5955 DE SOTO AVENUE SUITE 250 WOODLAND HILLS, CA 91367 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.05% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF CALIFORNIA | $685 | $0 | $685 | 7.93% |
| USB HEALTH LLC3 Filed as: USB HEALTH, LLC. | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | DELTA DENTAL OF CALIFORNIA | $176 | $0 | $176 | 2.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $971 | $35 | $1K | 13.32% |
| USB HEALTH LLC3 Filed as: USB HEALTH, LLC. | 99 WOOD AVENUE SUITE 501 ISELIN, NY 08830 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $163 | $217 | $380 | 5.03% |
| ARCHON LLC3 Filed as: ARCHON, LLC. | 225 WIRELESS BOULEVARD HAUPPAGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $161 | $161 | 2.13% |
| MERCER HEALTH AND BENEFITS, LLC3 | 800 MARKET STREET, SUITE 1800 ST. LOUIS, MO 63101 | UNITEDHEALTHCARE INSURANCE COMPANY | $469 | $0 | $469 | 15.01% |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 133 | $1.3M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 116 | $61K |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 133 | $962K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $21K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 111 | $9K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $15K |
| Prescription drug(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 133 | $1.3M |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.