| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $33K | $0 | $33K | 8.20% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $74K | $23K | $97K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 THIRD PARTY ADMINISTRATOR | Other fees; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Insurance services; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 12 | P.O. BOX 230495 GRAND RAPIDS, MI 49523 | $928K |
| THE PRUDENTIAL INSURANCE COMPANY OF EIN 22-1211670 THIRD PARTY ADMINISTRATOR | Consulting (general) Service code 16 | P.O. BOX 7639 PHILADELPHIA, PA 19176 | $31K |
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 | 1,634 | 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) | 1,634 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,634 | $0 |
| Dental | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,634 | $0 |
| Vision | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,634 | $0 |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,504 | $397K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,504 | $397K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,634 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 1,634 | $0 |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,504 | $397K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,634 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.