| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | VISION SERVICE PLAN (VSP) | $6K | — | $6K | 7.95% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16K | — | $16K | 27.79% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $39K | $0 | $39K | 123.70% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $158 | $158 | 0.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA INC EIN 54-0357120 BENEFIT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | — | $635K |
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 BENEFIT ADMINISTRATOR | Plan Administrator; Contract Administrator; Other fees Service code 13 | P.O. BOX 7827 PHILADELPHIA, PA 19176 | $45K |
| COMPSYCH EIN 35-3739783 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $0 |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 BENEFIT ADMINISTRATOR | Contract Administrator Service code 13 | 4818 STARKEY ROAD ROANOKE, VA 24018 | $0 |
| INGENIORX INC. EIN 82-3062245 THIRD PARTY ADMIN | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $0 |
| MERCER HEALTH & BENEFITS LLC EIN 34-2015463 THIRD PARTY ADMIN | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $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 | 1,124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA INC. | 2,004 | $834K |
| Vision(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA INC. | 2,004 | $908K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,124 | $31K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,026 | $206K |
| Prescription drug | ANTHEM HEALTH PLANS OF VIRGINIA INC. | 2,004 | $834K |
| Stop-loss / reinsurancereinsurance | ANTHEM HEALTH PLANS OF VIRGINIA INC. | 2,004 | $834K |
| Other(5 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,124 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,004 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.