| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN | P.O. BOX 850502 MINNEAPOLIS, MN 55485 | RELIASTAR LIFE INSURANCE COMPANY | $68K | — | $68K | 4.01% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA THE HATCHER AGENCY | 310 LOUISIANA STREET LITTLE ROCK, AR 72201 | RELIASTAR LIFE INSURANCE COMPANY | $35K | — | $35K | 2.08% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | RELIASTAR LIFE INSURANCE COMPANY | — | $2K | $2K | 0.11% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 0.69% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $288 | $288 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA EIN 54-0357120 CLAIMS PROCESSOR | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Contract Administrator Service code 12 | — | $118K |
| THE PRUDENTIAL INSURANCE COMPANY EIN 22-1211670 INSURER | Insurance services Service code 23 | — | $67K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 BENEFIT ADMINISTRATOR | Contract Administrator Service code 13 | — | $50K |
| HEALTH KEEPERS INC. EIN 54-1356687 CLAIMS PROCESSOR | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $38K |
| COMPSYCH EIN 35-3739783 TPA | Contract Administrator Service code 13 | — | $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 | 1,640 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,640 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | EYEMED VISION CARE | 1,894 | $100K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,640 | $1.3M |
| Short-term disability(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,640 | $3.0M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,640 | $1.3M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,890 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,894 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.