| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $4K | $4K | 0.33% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF ARIZONA | $21K | — | $21K | 2.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $28K | $3K | $31K | 3.33% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF ARIZONA | $17K | — | $17K | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DRIVE, SUITE 2000 CHICAGO, IL 60603 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10K | — | $10K | 5.54% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $320 | — | $320 | 0.17% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.06% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $5 | $1K | 6.18% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $465 | $2 | $467 | 2.06% |
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 | 3,438 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,478 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 575 | $206K |
| Dental(2 contracts) | DELTA DENTAL OF ARIZONA | 1,531 | $1.9M |
| Vision | VISION SERVICE PLAN | 2,124 | $391K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,832 | $1.5M |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,832 | $919K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,460 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,460 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.