| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 155 NORTH WACKER DRIVE SUITE 1500 CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $165K | — | $165K | 1.39% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $142K | — | $142K | 12.89% |
| HARVARD PRINTING GROUP5 | 175 US HIGHWAY 46 WEST FAIRFIELD, NJ 07004 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 0.14% |
| CAPFINANCIAL PARTNERS, LLC3 | DBA CAPTRUST FINANCIAL ADVISORS 4208 SIX FORKS ROAD, STE 1700 RALEIGH, NC 27609 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 1.29% |
| CAPFINANCIAL SECURITIES, LLC3 | 4208 SIX FORKS ROAD SUITE 1700 RALEIGH, NC 27609 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 1.23% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $24K | — | $24K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 155 NORTH WACKER DRIVE SUITE 1500 CHICAGO, IL 60606 | ALPHA DENTAL PROGRAMS, INC. | $5K | — | $5K | 4.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 10.00% |
| PHILLIP M. ERNEST & ASSOCIATES, INC4 | 3125 MARQUITA DRIVE FORT WORTH, TX 76116 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $7K | — | $7K | 26.65% |
| HIGGINBOTHAM INS AGENCY INC4 Filed as: HIGGINBOTHAM & ASSOCIATES | P.O. BOX 908 FORT WORTH, TX 76101 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $29 | — | $29 | 0.11% |
| BRIAN PARKER4 | 1110 COGBURN CT SHADY SHORES, TX 76208 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $10 | — | $10 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL INSURANCE CO. EIN 94-2761537 CLAIMS PROCESSING | Claims processing Service code 12 | — | $58K |
| CONEXIS EIN 20-0198855 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $34K |
| MERCER HEALTH & BENEFITS, LLC BROKER | Insurance agents and brokers Service code 22 | 155 NORTH WACKER DRIVE SUITE 1500 CHICAGO, IL 60606 | $11K |
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 | 3,205 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 2,880 | $11.9M |
| Dental | ALPHA DENTAL PROGRAMS, INC. | 469 | $127K |
| Vision | VISION SERVICE PLAN | 1,719 | $237K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,824 | $1.3M |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,407 | $1.2M |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,407 | $1.2M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,406 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,407 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.