| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $65K | — | $65K | 11.40% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | ATL 4565 PAYSPHERE CIR CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $48K | — | $48K | 27.58% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN | PO BOX 850502 MINNEAPOLIS, MN 55485 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $33K | — | $33K | 27.66% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENIFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 6.14% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN | PO BOX 850502 MINNEAPOLIS, MN 55485 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $24K | — | $24K | 23.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 6.97% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN | PO BOX 850502 MINNEAPOLIS, MN 55485 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $25K | — | $25K | 26.65% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 6.77% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | ADMINISTRATON, LLC ATL 4565 PAYSPHER CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16K | — | $16K | 28.61% |
| USI INSURANCE SERVICES LLC3 | STE 1002 7 E CONGRESS ST SAVANNAH, GA 31401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $166 | — | $166 | 2.85% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES, LLC CHICAGO | SERIES C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DR CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $121 | $32 | $153 | 2.63% |
| SLADE, MICHAEL, RAWLS3 | 8215 ROYAL SAINT GEORGES WAY DULUTH, GA 30097 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 3.23% |
| HARPER, CHRISTOPHER, WILKES3 | 5251 PIKES PEAK CT MARIETTA, GA 30062 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 1.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE COMPA EIN 59-1031071 CONTRACT ADMINISTRATOR | Participant communication; Named fiduciary; Float revenue; Claims processing; Contract Administrator; Direct payment from the plan; Other services; Non-monetary compensation Service code 12 | — | $1.5M |
| EVERNORTH BEHAVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMINISTRATOR | Participant communication; Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $47K |
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 | 2,418 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 53 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,471 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 30 | $225 |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,207 | $568K |
| Short-term disability(4 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 2,207 | $322K |
| Long-term disability(2 contracts, 2 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,207 | $499K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY & AFFILIATES (CIGNA) | 2,947 | $2.6M |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,774 | $257K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,947 | — |
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.