| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VARIOUS - SEE ATTACHMENT3 | 4333 EDGEWOOD ROAD NE CEDAR RAPIDS, IA 52499 | TRANSAMERICA LIFE INSURANCE COMPANY | $14K | — | $14K | 0.56% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $36K | — | $36K | 2.04% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $50K | $44K | $94K | 6.53% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DRIVE SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $16K | — | $16K | 2.15% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 0.70% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DRIVE SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 1.84% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HYATT LEGAL PLANS | $14K | $2K | $16K | 11.97% |
| MERCER HEALTH AND BENEFITS, LLC3 | P.O. BOX 100260 PASADENA, CA 91189 | HYATT LEGAL PLANS | — | $233 | $233 | 0.18% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $170 | $170 | 0.66% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $144 | — | $144 | 2.06% |
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 | 8,611 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,684 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 12,295 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF COLORADO | 449 | $2.8M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 14,884 | $915K |
| Life insurance(2 contracts) | TRANSAMERICA LIFE INSURANCE COMPANY | 12,154 | $3.7M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 9,071 | $1.4M |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF COLORADO | 449 | $2.8M |
| Other(6 contracts, 5 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 9,776 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 14,884 | — |
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.