| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. Filed as: ANTHEM INSURANCE COMPANIES, INC | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | FOUR EVER LIFE INS CO DBA GEOBLUE | — | $28K | $28K | 8.00% |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER H&B ADMIN LLC | PO BOX 310502 DES MOINES, IA 50331 | AMERICAN HERITAGE LIFE INS CO DBA ALLSTATE BENEFITS | — | $6K | $6K | 6.09% |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER H&B ADMIN LLC | PO BOX 310502 DES MOINES, IA 50331 | AMERICAN HERITAGE LIFE INS CO DBA ALLSTATE BENEFITS | — | $26K | $26K | 28.31% |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AMERICAN HERITAGE LIFE INS CO DBA ALLSTATE BENEFITS | — | $1K | $1K | 1.21% |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER H&B ADMIN LLC | PO BOX 310502 DES MOINES, IA 50331 | AMERICAN HERITAGE LIFE INS CO DBA ALLSTATE BENEFITS | — | $9K | $9K | 13.01% |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AMERICAN HERITAGE LIFE INS CO DBA ALLSTATE BENEFITS | — | $825 | $825 | 1.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INS CO NONE | Float revenue; Other services; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 22703 NETWORK PLACE CHICAGO, IL 60673 | $1.9M |
| MERCER HEALTH & BENEFITS NONE | Consulting fees Service code 70 | PO BOX 100260 PASADENA, CA 91189 | $259K |
| EXPRESS SCRIPTS INC EIN 22-3461740 NONE | Employee (plan) Service code 30 | — | $154K |
| DELTA DENTAL EIN 84-0568337 NONE | Employee (plan) Service code 30 | — | $153K |
| HEALTH YOU LLC NONE | Other services Service code 49 | 3314 MESA RD COLORADO SPRINGS, CO 80904 | $115K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Employee (plan) Service code 30 | — | $63K |
| AETNA BEHAVIORAL HEALTH NONE | Plan Administrator Service code 14 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $54K |
| HOLLAND AND HART EIN 84-0382505 NONE | Legal Service code 29 | — | $52K |
| RENE HERNANDEZ NONE | Copying and duplicating Service code 36 | ONE TIERRA VISTA LAGUNA HILLS, CA 92653 | $48K |
| BROCK AND CO CPAS PC EIN 84-0930288 NONE | Accounting (including auditing) Service code 10 | — | $33K |
| WAGEWORKS INC NONE | Plan Administrator Service code 14 | PARK PL 4TH FLOOR SAN MATEO, CA 94403 | $19K |
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 | 3,044 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,065 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FOUR EVER LIFE INS CO DBA GEOBLUE | 38 | $350K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 7,472 | $3.7M |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 7,472 | $3.7M |
| Long-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 7,472 | $3.7M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 3,061 | $2.1M |
| Other(5 contracts, 3 carriers) | AETNA LIFE INSURANCE CO | 7,472 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,472 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.