| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENIFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | SECURIAN LIFE INSURANCE COMPANY | — | $28K | $28K | 2.39% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $21K | $21K | 2.02% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE | $74K | — | $74K | 20.89% |
| DANIEL COBB3 | 2238 TAYSIDE XING NW KENNESAW, GA 30152 | AMERICAN HERITAGE LIFE | $731 | — | $731 | 0.21% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $362 | $362 | 0.25% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $6K | — | $6K | 6.83% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS - ATL | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $1.5M |
| PAYFLEX SYSTEMS USA INC CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 10802 FARNAM DRIVE, STE 100 OMAHA, NE 68154 | $114K |
| EXPRESS SCRIPTS EIN 43-1420563 CLAIMS PROCESSING | Contract Administrator Service code 13 | 525 WEST MONROE STREET CHICAGO, IL 60661 | $79K |
| LIFEWORKS US INC. EIN 81-1114266 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 201 17TH ST NW, SUITE 630 ATLANTA, GA 30363 | $25K |
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 | 2,376 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 37 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE | 636 | $429K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,316 | $2.6M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 2,054 | $417K |
| Life insurance | SECURIAN LIFE INSURANCE COMPANY | 8,422 | $1.2M |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,316 | $3.6M |
| Long-term disability(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,038 | $1.1M |
| Prescription drug | HMSA | 6 | $75K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE | 2,283 | $745K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 3,038 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,422 | — |
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."
No prospect flags tripped on this filing.