| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING IN | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $21K | $21K | 1.58% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $13K | — | $13K | 0.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON BCBS EIN 22-0999690 3RD PARTY | Insurance agents and brokers; Contract Administrator Service code 13 | — | $588K |
| NISA INVESTMENT ADVISORS, LLC NONE | Investment management Service code 28 | P.O. BOX 790379 ST. LOUIS, MO 631790379 | $405K |
| CALLAN ASSOCIATES EIN 94-2192581 3RD PARTY | Investment advisory (plan) Service code 27 | — | $56K |
| MERCER NONE | Insurance agents and brokers Service code 22 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | $45K |
| WELLS FARGO EIN 94-1347393 TRUSTEE | Custodial (other than securities); Trustee (bank, trust company, or similar financial institution) Service code 18 | — | $35K |
| BLACKROCK FINANCIAL MANAGEMENT INC. NONE | Investment management Service code 28 | P.O. BOX 978884 DALLAS, TX 75397 | $33K |
| CVS/CAREMARK EIN 05-0494040 NONE | Insurance services Service code 23 | — | $24K |
| AETNA EIN 06-6033492 3RD PARTY | Claims processing; Contract Administrator Service code 12 | — | $9K |
| MORGAN LEWIS & BOCKIUS LLP NONE | Contract Administrator Service code 13 | P.O. BOX 8500 S-6050 PHILADELPHIA, PA 191786050 | $5K |
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 | 2,919 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,919 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARTFORD LIFE AND ACCIDENT | 343 | $157K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,036 | $1.3M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,036 | $1.3M |
| Other | HARTFORD LIFE AND ACCIDENT | 2,036 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,036 | — |
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.