| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $58K | — | $58K | 3.03% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $28K | $28K | 1.48% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $19K | — | $19K | 6.38% |
| FLEXVISION3 | 15400 CALHOUN DRIVE ROCKVILLE, MD 20855 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $8K | $8K | 2.73% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | $23K | $825 | $23K | 10.66% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | $23K | $42 | $23K | 10.30% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 0.63% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | — | $68 | $68 | 0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | — | $10 | $10 | 0.00% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $495 | $17K | 13.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $42 | $17K | 12.68% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | — | $825 | $825 | 0.63% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | METROPOLITAN LIFE INSURANCE COMPANY | — | $41 | $41 | 0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | — | $6 | $6 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $5K | $713 | $6K | 11.33% |
| D'ANN DABELL4 | 1174 N 2000 E LAYTON, UT 84040 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $8K | — | $8K | 25.95% |
| TERESA JOHNSON4 | 1755 OAK HILLS DR COLORADO SPRINGS, CO 80919 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $184 | — | $184 | 0.62% |
| LISA L BASS4 Filed as: LISA L. BASS | 16973 BRIDGETON LN HUNTERSVILLE, NC 28078 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $157 | — | $157 | 0.53% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $79 | — | $79 | 5.08% |
| FLEXVISION3 | 15400 CALHOUN DR. ROCKVILLE, MD 20855 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $34 | $34 | 2.19% |
No Schedule C service providers reported on this filing.
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 | 3,032 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 38 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,070 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 18 | $65K |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 18 | $65K |
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 4,361 | $295K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 3,032 | $1.9M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 3,032 | $1.9M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 3,032 | $1.9M |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 18 | $65K |
| Other(6 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 7,855 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,855 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.