| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | — | $42 | $42 | 0.01% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 0.70% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $811 | — | $811 | 0.69% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $332 | — | $332 | 0.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | PO BOX 310502 DES MOINES, IA 50331 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 65.00% |
| VARIOUS - SEE ATTACHED4 Filed as: VARIOUS - SEE ATTACHMENT | ONE PRE-PAID WAY ADA, OK 74820 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $5K | — | $5K | 28.70% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | PO BOX 310502 DES MOINES, IA 50331 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 65.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | PO BOX 310502 DES MOINES, IA 50331 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 65.00% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM AUSTIN, INC. | 221 WEST 6TH ST STE 1400 AUSTIN, TX 78701 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $967 | — | $967 | 14.99% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM AUSTIN, INC. | 221 WEST 6TH ST., STE. 1400 AUSTIN, TX 78701 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $967 | — | $967 | 15.00% |
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 | 794 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 799 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 104 | $17K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,457 | $491K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,283 | $78K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,475 | $185K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 794 | $117K |
| Other(6 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,475 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,475 | — |
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.