| 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 | LIFE INSURANCE COMPANY OF NORTH AMERICA (CIGNA) | $19K | — | $19K | 5.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $43K | — | $43K | 16.00% |
| DAVID M COUGHLIN3 | 751 HEBRON PARKWAY, SUITE 220 LEWISVILLE, TX 75057 | CONTINENTAL AMERICAN INSURANCE CO | $8K | — | $8K | 4.20% |
| MARY E MERICA3 | 5211 N 150 ST OMAHA, NE 68116 | CONTINENTAL AMERICAN INSURANCE CO | $3K | — | $3K | 1.62% |
| DEELORALEE A COUGHLIN3 Filed as: DEELORALEE COUGHLIN | 4906 N 139TH AVE OMAHA, NE 68164 | CONTINENTAL AMERICAN INSURANCE CO | $3K | — | $3K | 1.37% |
| MITCHELL FRIEHE & ASSOCIATES INC3 Filed as: MITCHELL FRIEHE & ASSOCIATES | 16909 PALISADE S DR OMAHA, NE 68136 | CONTINENTAL AMERICAN INSURANCE CO | $2K | — | $2K | 1.19% |
| DANIEL E ELLIS3 Filed as: DANIEL ELLIS | 751 HEBRON PARKWAY, SUITE 220 LEWISVILLE, TX 75057 | CONTINENTAL AMERICAN INSURANCE CO | $2K | — | $2K | 0.91% |
| DIANE BANG3 | 7350 N 156TH ST BENNINGTON, NE 68007 | CONTINENTAL AMERICAN INSURANCE CO | $1K | — | $1K | 0.70% |
| DAVID J MCCLELLAN3 Filed as: DAVID J BECK | 16636 FREDERICK CIRCLE, STE 250 OMAHA, NE 68130 | CONTINENTAL AMERICAN INSURANCE CO | $1K | — | $1K | 0.66% |
| MARK FRIEHE3 | 4611 S 96TH ST, SUITE 101 OMAHA, NE 68127 | CONTINENTAL AMERICAN INSURANCE CO | $689 | — | $689 | 0.37% |
| THOMAS E SHEFFIELD3 | PO BOX 151 MCCOOL JUNCTION, NE 68401 | CONTINENTAL AMERICAN INSURANCE CO | $595 | — | $595 | 0.32% |
| ANN C BECK3 | 15606 ELM ST STE 105 OMAHA, NE 68130 | CONTINENTAL AMERICAN INSURANCE CO | $422 | — | $422 | 0.22% |
| KARMIE K COUGHLIN3 | 4253 HUNT DR APT 1607 CARROLLTON, TX 75010 | CONTINENTAL AMERICAN INSURANCE CO | $416 | — | $416 | 0.22% |
| CYNTHIA D WELKEN-PLACE3 | 14710 WEST DODGE ROAD, SUITE 200 OMAHA, NE 68154 | CONTINENTAL AMERICAN INSURANCE CO | $335 | — | $335 | 0.18% |
| MICHAEL COPPESS3 | 4910 DODGE ST STE 107 OMAHA, NE 68132 | CONTINENTAL AMERICAN INSURANCE CO | $82 | — | $82 | 0.04% |
| MICHAEL S CEJKA3 | 613 CEDAR ST HICKMAN, NE 68372 | CONTINENTAL AMERICAN INSURANCE CO | $35 | — | $35 | 0.02% |
| KIMBERLY DIAN CROCKETT3 Filed as: KIMBERLY D CROCKETT | 732 SILVER SANDS DR CORDOVA, TN 38018 | CONTINENTAL AMERICAN INSURANCE CO | $33 | — | $33 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 5.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 15.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 606740001 | METROPOLITAN LIFE INSURANCE COMPANY | $39K | $5K | $43K | 111.93% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 5.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA LIFE INSURANCE CO OF NEW YORK | $7 | — | $7 | 1.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $1.0M |
| CIGNA EIN 59-1031071 ADMIN SVCS AGREEMENT | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Other services; Contract Administrator; Direct payment from the plan Service code 12 | — | $72K |
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 | 1,544 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,544 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 302 | $44K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,994 | $175K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $39K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA (CIGNA) | 1,991 | $360K |
| Other(7 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,994 | $603K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,994 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.