| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 1050 CONNECTICUT AVENUE NW SUITE 700 WASHINGTON, DC 20036 | GHMSI | $125K | $75K | $200K | 3.26% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF VIRGINIA | $18K | — | $18K | 4.52% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 1166 AVENUE OF THE AMERICAS 22ND FLOOR NEW YORK, NY 10036 | SUN LIFE ASSURANCE COMPANY OF CANADA | $13K | — | $13K | 3.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE O/B/O TBE FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 13.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERIFLEX NONE | Claims processing Service code 12 | 7 CARNEGIE PLAZA SUITE 200 CHERRY HILL, NJ 08003 | $274K |
| GOVERNMENT SERVICE ADMINISTRATORS NONE | Claims processing; Contract Administrator Service code 12 | 11320 RANDOM HILLS ROAD SUITE 115 FAIRFAX, VA 22030 | $187K |
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 | 717 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 725 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GHMSI | 1,142 | $6.2M |
| Dental | DELTA DENTAL OF VIRGINIA | 1,212 | $393K |
| Vision(3 contracts, 3 carriers) | GHMSI | 1,142 | $6.2M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 867 | $377K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 867 | $377K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 867 | $377K |
| Prescription drug | GHMSI | 1,142 | $6.2M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 867 | $377K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,212 | — |
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.