| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 333 S 7TH ST STE 1600 MINNEAPOLIS, MN 55402 | DDMN ASO, LLC, D.B.A. DELTA DENTAL OF MINNESOTA | $3K | — | $3K | 0.76% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | PO BOX 850502 MINNEAPOLIS, MN 55485 | BCBSMN, INC. D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $18K | — | $18K | 16.08% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | PO BOX 850502 MINNEAPOLIS, MN 55485 | RELIASTAR LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSMN, INC., D.B.A. BLUE CROSS AND EIN 41-0984460 INSURANCE CARRIER | Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $200K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CONTRACT ASMINISTRATOR | Contract Administrator Service code 13 | — | $25K |
| DDMN ASO, LLC DBA DELTA DENTAL MN EIN 41-1905554 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | -$782 |
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 | 488 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 499 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBSMN, INC. D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 396 | $115K |
| Dental | DDMN ASO, LLC, D.B.A. DELTA DENTAL OF MINNESOTA | 407 | $340K |
| Vision | BCBSMN, INC. D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 396 | $115K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 488 | $93K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 488 | $93K |
| Prescription drug | BCBSMN, INC. D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 396 | $115K |
| Stop-loss / reinsurancereinsurance | BCBSMN, INC. D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 396 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 488 | — |
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."
No prospect flags tripped on this filing.