| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | BLUE CROSS BLUE SHIELD OF ARIZONA | $288K | $0 | $288K | 3.46% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF ARIZONA | $52K | $0 | $52K | 7.41% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | $3K | $20K | 9.28% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $2K | $13K | 9.41% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $3K | $14K | 9.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $6K | $0 | $6K | 7.11% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $58K | $0 | $58K | 70.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $57K | $0 | $57K | 70.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $54K | $0 | $54K | 70.00% |
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH & BENEFITS LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $4K | $0 | $4K | 10.13% |
| JP GRIFFIN COMPANIES LLC4 | 6720 NORTH SCOTTSDALE ROAD SUITE 310 PARADISE VALLEY, AZ 85253 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $686 | $0 | $686 | 1.86% |
| ZAINUDDEAN JEEWANJEE4 | 333 ASCENTE COMMONS, SUITE 103 SAN JOSE, CA 95125 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $68 | $0 | $68 | 0.18% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: HUB INTERNATIONAL INSURANCE | PO BOX 2158 RIVERSIDE, CA 92516 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $34 | $0 | $34 | 0.09% |
| TRACY KATZ LLC4 | 1662 EAST MELTON ROAD BIRMINGHAM, MI 48009 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $22 | $0 | $22 | 0.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $615 | $3K | 9.82% |
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 | 976 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 997 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 2,339 | $8.3M |
| Dental | DELTA DENTAL OF ARIZONA | 1,920 | $700K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,733 | $90K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,380 | $251K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 927 | $137K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 927 | $137K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 2,339 | $8.3M |
| Other(6 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,380 | $529K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,339 | — |
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.