| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | ATTN KAREN PETERSON 333 S 7TH ST, NO. 1600 MINNEAPOLIS, MN 55402 | MEDICA INSURANCE COMPANY | -$3 | — | -$3 | -0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MINNESOTA INC. | ATTN B. FITZPATRICK, J. RICHMAN 1600 UTICA AVE S, NO. 600 MINNEAPOLIS, MN 55416 | MEDICA INSURANCE COMPANY | -$21 | — | -$21 | -0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICA EIN 41-1479417 CONTRACT ADMNSTRTR | Other fees; Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $608K |
| DDMN ASO, LLC EIN 41-1905554 CONTRACT ADMNSTRTR | Contract Administrator; Direct payment from the plan Service code 13 | — | $35K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 TRUSTEE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $8K |
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 | 846 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 859 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | MEDICA INSURANCE COMPANY | 827 | $690K |
| Other | SAND CREEK GROUP, LTD | 1,003 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,003 | — |
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.