| 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 60674 | SUN LIFE ASSURANCE COMPANY OF CANADA | $73K | — | $73K | 5.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Other services; Direct payment from the plan; Claims processing; Other fees Service code 12 | — | $2.6M |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $156K |
| UNITED BEHAVIORAL HEALTH EIN 20-2149493 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $60K |
| VISION SERVICE PLAN EIN 36-3560825 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $58K |
| WAGEWORKS, INC. EIN 94-3351864 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $21K |
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 | 3,140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 42 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 65 | $485K |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 17 | $139K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,152 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,152 | — |
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.