| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $54K | $0 | $54K | 1.80% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $92K | $0 | $92K | 7.12% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | PO BOX 850502 MINNEAPOLIS, MN 55485 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $934 | $0 | $934 | 0.07% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $280 | $280 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $42K | $0 | $42K | 3.23% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $23K | $0 | $23K | 14.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 NORTH WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 1.80% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | GPO BOX 27447 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $116 | $24K | $25K | 18.18% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 NORTH WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | $0 | $2K | 1.64% |
| MERCER HEALTH AND BENEFITS, LLC3 | PO BOX 730182 DALLAS, TX 75373 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $3K | $0 | $3K | 8.77% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $6K | $0 | $6K | 14.81% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | PO BOX 850502 MINNEAPOLIS, MN 55485 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 18.95% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $208 | $0 | $208 | 1.05% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | GPO BOX 27447 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $3K | $3K | 19.12% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | PO BOX 850502 MINNEAPOLIS, MN 55485 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 17.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | GPO BOX 27447 NEW YORK, NY 10087 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $2K | $2K | 18.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $164 | $0 | $164 | 14.16% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $5 | $0 | $5 | 14.29% |
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 | 1,258 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 429 | $3.3M |
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 2,482 | $1.3M |
| Vision(5 contracts) | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 1,583 | $241K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,253 | $1.3M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,253 | $1.3M |
| Long-term disability(4 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,253 | $1.5M |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 429 | $3.3M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,253 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,482 | — |
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."
No prospect flags tripped on this filing.