| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | BLUE CROSS AND BLUE SHIELD OF GEORGIA | $36K | — | $36K | 3.08% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | $1K | $11K | 8.58% |
| AXA ASSISTANCE, USA3 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $40 | $40 | 0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | BLUE CROSS AND BLUE SHIELD OF GEORGIA | $7K | — | $7K | 7.50% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS - ATL | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION INSURANCE | $2K | — | $2K | 13.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPPSYCH EIN 35-3739783 THIRD PARTY ADMINISTRATOR | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Plan Administrator Service code 12 | — | $522 |
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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF GEORGIA | 299 | $1.2M |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA | 116 | $96K |
| Vision | EYEMED VISION INSURANCE | 253 | $14K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 134 | $134K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 134 | $134K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 134 | $134K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 134 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.