| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | HARTFORD LIFE AND ACCIDENT | $294K | — | $294K | 4.96% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING IN | 4565 PAYSPHERE CIRCLE CHICAGO, IA 60674 | HARTFORD LIFE AND ACCIDENT | — | $84K | $84K | 1.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA INC EIN 54-0357120 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other services Service code 12 | — | $11.5M |
| PREMISE HEALTH SYSTEMS, LLC EIN 23-3057155 NONE | Other services Service code 49 | — | $6.4M |
| EMPLOYEE PHARMACY LLC EIN 82-2572721 NONE | Contract Administrator Service code 13 | — | $5.9M |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Claims processing; Contract Administrator Service code 12 | — | $5.4M |
| THE STAYWELL COMPANY, LLC EIN 94-3151780 NONE | Other fees; Contract Administrator Service code 13 | — | $1.5M |
| ALIGHT REED GROUP MGMT LLC EIN 13-5123390 NONE | Other services Service code 49 | — | $942K |
| KEYSTONE HEALTH PLAN CENTRAL EIN 23-2399845 NONE | Contract Administrator; Claims processing Service code 12 | — | $327K |
| HEALTH ADVOCATE SOLUTIONS, INC EIN 23-3080019 NONE | Consulting (general) Service code 16 | — | $312K |
| ANTEHM HEALTH PLANS OF VIRGINIA INC | Other commissions; Insurance agents and brokers; Non-monetary compensation Service code 22 | — | $239K |
| CAPITAL ADVANTAGE ASSURANCE CO EIN 45-5492167 NONE | Contract Administrator; Claims processing Service code 12 | — | $8K |
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 | 12,900 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 12,900 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 32,886 | $12.1M |
| Vision | VISION SERVICE PLAN | 6,673 | $1.7M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 14,052 | $8.3M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 14,234 | $5.9M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 14,234 | $5.9M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 15,165 | $8.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 32,886 | — |
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.