| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO US, IL 60674 | MINNESOTA LIFE INSURANCE COMPANY | $0 | $256K | $256K | 2.45% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO US, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $32K | $0 | $32K | 0.71% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED THOMAS MAXWELL II | 2591 DALLAS PKWY STE 203 FRISCO US, TX 75034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $20K | $20K | 0.44% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED THOMAS MAXWELL II | 2591 DALLAS PKWY STE 203 FRISCO US, TX 75034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $20K | $20K | 0.96% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO US, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | $0 | $15K | 0.72% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED THOMAS MAXWELL II | 2591 DALLAS PKWY STE 203 FRISCO US, TX 75034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $10K | $10K | 2.36% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO US, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 0.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Contract Administrator; Claims processing Service code 12 | — | $7.4M |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator Service code 12 | — | $2.1M |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing; Contract Administrator Service code 12 | — | $1.2M |
| BEACON HEALTH OPTIONS, INC EIN 54-1414194 NONE | Insurance services; Claims processing; Direct payment from the plan Service code 12 | — | $561K |
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 | 12,349 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7,242 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 19,591 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,704 | $290K |
| Vision | VISION SERVICE PLAN | 10,910 | $3.2M |
| Life insurance | MINNESOTA LIFE INSURANCE COMPANY | 17,761 | $10.4M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 12,223 | $4.5M |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 18,360 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 18,360 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.