| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $32K | $32K | 1.49% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $21K | — | $21K | 0.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HM LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HM LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON BCBS EIN 22-0999690 3RD PARTY | Insurance agents and brokers; Contract Administrator Service code 13 | — | $626K |
| MERCER EIN 13-2834414 NONE | Insurance agents and brokers Service code 22 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | $327K |
| CVS/CAREMARK EIN 05-0494040 NONE | Insurance services Service code 23 | — | $98K |
| BLACKROCK FINANCIAL MANAGEMENT INC. EIN 98-0510248 NONE | Investment management Service code 28 | P.O. BOX 978884 DALLAS, TX 75397 | $66K |
| MORGAN LEWIS & BOCKIUS LLP EIN 23-0891050 NONE | Contract Administrator Service code 13 | P.O. BOX 8500 S-6050 PHILADELPHIA, PA 191786050 | $25K |
| NORTHERN TRUST EIN 36-1561860 3RD PARTY | Trustee (bank, trust company, or similar financial institution); Other fees; Distribution (12b-1) fees; Other services Service code 21 | — | $25K |
| KREISCHER MILLER EIN 23-1980475 3RD PARTY | Accounting (including auditing) Service code 10 | — | $17K |
| AETNA EIN 06-6033492 3RD PARTY | Claims processing; Contract Administrator Service code 12 | — | $15K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,420 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARTFORD LIFE AND ACCIDENT | 464 | $198K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,866 | $2.2M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,866 | $2.2M |
| Stop-loss / reinsurancereinsurance(2 contracts) | HM LIFE INSURANCE COMPANY | 226 | $156K |
| Other | HARTFORD LIFE AND ACCIDENT | 2,866 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,866 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.