| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCERT HEALTH AND BENEFITS LLC | 1050 CONNECTICUT AVE NW SUITE 700 WASHINGTON, DC 20036 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | — | $7K | $7K | 0.38% |
| OLSON BENEFIT GROUP, LLC3 | 3509 PINETREE TERRACE FALLS CHURCH, VA 22041 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | — | $6K | $6K | 0.32% |
| MATHER & STROHL ADMIN SVC INC5 Filed as: MATHER & STROHL ADMINISTRATIVE SERV | 12404 PARK CENTRAL DRIVE SUITE 400 DALLAS, TX 75251 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | — | $84 | $84 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $2K | $6K | 4.41% |
| OLSON BENEFIT GROUP, LLC3 | 1011 SCARBOROUGH AVENUE REHOBOTH BEACH, DE 19971 | METROPOLITAN LIFE INSURANCE COMPANY | $399 | $0 | $399 | 0.31% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $188 | $4K | 6.04% |
| OLSON BENEFIT GROUP, LLC3 | 1011 SCARBOROUGH AVENUE REHOBOTH BEACH, DE 19971 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 2.78% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $236 | $3K | 5.63% |
| OLSON BENEFIT GROUP, LLC3 | 1011 SCARBOROUGH AVENUE REHOBOTH BEACH, DE 19971 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 2.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $179 | $4K | 9.09% |
| OLSON BENEFIT GROUP, LLC3 | 1011 SCARBOROUGH AVENUE REHOBOTH BEACH, DE 19971 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 3.81% |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | VISION SERVICE PLAN | $823 | $0 | $823 | 5.52% |
| OLSON BENEFIT GROUP, LLC3 | 1011 SCARBOROUGH REHOBOTH BEACH, DE 19971 | VISION SERVICE PLAN | $252 | — | $252 | 1.69% |
| EMPLOYEE NAVIGATOR, LLC5 | 7979 OLD GEORGETOWN RD STE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | — | $24 | $24 | 0.16% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $265 | $11 | $276 | 11.57% |
| OLSON BENEFIT GROUP, LLC3 | 1011 SCARBOROUGH AVENUE REHOBOTH BEACH, DE 19971 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $93 | — | $93 | 3.90% |
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 | 140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 202 | $1.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 311 | $128K |
| Vision | VISION SERVICE PLAN | 87 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 140 | $49K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 140 | $60K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 140 | $41K |
| Prescription drug | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 202 | $1.8M |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 140 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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.