| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | AXIS INSURANCE COMPANY | $4K | — | $4K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE & HEALTH INS EIN 95-4331852 CONTRACT/PLAN ADMIN | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $455K |
| EXPRESS SCRIPTS, INC EIN 43-1420563 PHARMACY BENEFIT MANAGER | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $41K |
| PRUDENTIAL INS COMPANY OF AMERICA EIN 22-1211670 ADMIN SERVICES | Contract Administrator; Claims processing Service code 12 | — | $1K |
| HEALTHTRUST PURCHASING GROUP THIRD PARTY ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 44 FRANKLIN ROAD, SUITE 400 BRENTWOOD, TN 37027 | $0 |
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 | 1,023 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,134 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,311 | $1.7M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 1,510 | $4K |
| Vision | VISION SERVICE PLAN | 596 | $102K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 969 | $200K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 777 | $222K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 148 | $1.2M |
| Stop-loss / reinsurancereinsurance(4 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,311 | $448K |
| Other(6 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,971 | $440K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,971 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.