| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $22K | $22K | 1.25% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSHPERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $21K | $21K | 1.25% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 1.25% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $6 | $6 | 1.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMINISTRATOR | Named fiduciary; Contract Administrator; Direct payment from the plan; Float revenue; Non-monetary compensation; Claims processing; Participant communication; Other services Service code 12 | — | $4.3M |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 ADMINISTRATOR | Contract Administrator Service code 13 | — | $167K |
| CIGNA | Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services Service code 12 | — | $7K |
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 | 5,632 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 476 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 6,636 | $1.7M |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 6,337 | $716K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 7,147 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,147 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.