| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE SUITE 1500 CHICAGO, IL 60611 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $158K | — | $158K | 2.28% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $72K | — | $72K | 1.04% |
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE SUITE 1500 CHICAGO, IL 60611 | KAISER FOUNDATION HEALTH PLAN INC | $64K | — | $64K | 2.12% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DRIVE SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $33K | — | $33K | 1.11% |
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE 15TH FLOOR CHICAGO, IL 60611 | AETNA LIFE INSURANCE COMPANY | $24K | — | $24K | 1.78% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE COMPANY | $9K | — | $9K | 0.69% |
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE 15TH FLOOR CHICAGO, IL 60611 | AETNA HEALTH, INC. | $27K | — | $27K | 2.04% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA HEALTH, INC. | $10K | — | $10K | 0.72% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 0.87% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $1K | $1K | 0.90% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $4K | $399 | $5K | 4.79% |
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVE STE 1500 CHICAGO, IL 60611 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $4K | — | $4K | 3.81% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $169 | $169 | 0.24% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $200 | $200 | 0.44% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $17K | $77 | $17K | 43.28% |
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 | 1,289 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,295 | $12.7M |
| Dental(4 contracts, 4 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,295 | $8.6M |
| Vision(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,296 | $7.0M |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,336 | $7.0M |
| Short-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,336 | $7.0M |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,336 | $7.0M |
| Prescription drug(4 contracts, 4 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,295 | $12.7M |
| Other(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,336 | $7.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,336 | — |
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.