| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSUR CO | $8K | — | $8K | 3.78% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 1225 17TH ST STE 2100 DENVER, CO 802025521 | SYMETRA LIFE INSURANCE COMPANY | $13K | — | $13K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSUR CO | $6K | — | $6K | 5.66% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSUR CO | $11K | — | $11K | 10.70% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSUR CO | $1K | — | $1K | 3.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSUR CO EIN 59-1031071 CLAIM ADMINISTRATION | Float revenue; Contract Administrator; Named fiduciary; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $479K |
| MERCER HEALTH & BENEFITS BROKER/CONSULTANT | Consulting (general) Service code 16 | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | $31K |
| BKD LLP EIN 44-0160260 AUDITORS | Accounting (including auditing) Service code 10 | — | $22K |
| CIGNA | Participant communication; Named fiduciary; Non-monetary compensation; Float revenue; Other services; Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $0 |
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 | 1,013 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 56 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 3 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,072 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | EYEMED VISION CARE | 967 | $39K |
| Life insurance(2 contracts) | CIGNA HEALTH AND LIFE INSUR CO | 860 | $317K |
| Long-term disability | CIGNA HEALTH AND LIFE INSUR CO | 531 | $107K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSUR CO | 1,013 | $507K |
| Other(2 contracts) | CIGNA HEALTH AND LIFE INSUR CO | 860 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,013 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.