| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $387 | — | $387 | 0.17% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $167 | — | $167 | 0.20% |
| 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 | $3K | $178 | $4K | 5.26% |
| 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 | $3K | $155 | $3K | 5.26% |
| 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 | $2K | $84 | $2K | 5.27% |
| VARIOUS - SEE ATTACHED4 Filed as: VARIOUS - SEE ATTACHMENT | ONE PRE-PAID WAY ADA, OK 74820 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $3K | — | $3K | 12.74% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 14.33% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC | 221 WEST 6TH ST AUSTIN, TX 78701 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $871 | — | $871 | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC | 221 WEST 6TH ST. AUSTIN, TX 78701 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $323 | — | $323 | 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 | 766 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 780 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 169 | $78K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,444 | $708K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,444 | $688K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,309 | $226K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 766 | $82K |
| Other(8 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,950 | $175K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,950 | — |
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.