| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $56K | — | $56K | 6.71% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | — | $16K | 2.88% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | BCBSM, INC. | $658K | — | $658K | 146.01% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS(*) | — | CIGNA HEALTH AND LIFE UNSURANCE COMPANY AND AFFILIATES (CIGNA) | $20K | $0 | $20K | 9.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $0 | $363K | $363K | 245.22% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE COMPANY NY | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSM, INC. EIN 41-0984460 CLAIM ADMINISTRATION | Float revenue; Insurance agents and brokers; Shareholder servicing fees; Contract Administrator; Other fees; Other commissions; Claims processing; Insurance brokerage commissions and fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.3M |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATION | Contract Administrator; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Float revenue Service code 12 | — | $330K |
| CIGNA | Claims processing; Float revenue; Other services; Participant communication; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $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 | 4,217 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 2,561 | $273K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 8,295 | $828K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 4,375 | $148K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,210 | $562K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | BCBSM, INC. | 6,463 | $649K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,295 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.