| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | PO BOX 310502 DES MOINES, IA 503310502 | HYATT LEGAL PLANS | $1 | — | $1 | 7.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Float revenue; Claims processing; Participant communication; Other services; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Contract Administrator Service code 12 | — | $4.1M |
| BCBSM, INC. EIN 41-0984460 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $99K |
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 | 3,620 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 85 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3,333 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,038 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DDMN ASO, LLC | 6,785 | $0 |
| Vision | VISION SERVICE PLAN | 0 | $26K |
| Life insurance(3 contracts) | SECURIAN LIFE INSURANCE COMPANY | 3,924 | $91K |
| Short-term disability(3 contracts) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,670 | $16K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,198 | $39K |
| Stop-loss / reinsurancereinsurance | BCBSM | 4,577 | $0 |
| Other | HYATT LEGAL PLANS | 0 | $13 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,785 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.