| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH & BENEFITS ADMIN 4059 | PO BOX 310502 DES MOINES, IA 50331 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $3K | $3K | 1.31% |
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH & BENEFITS ADMIN 4059 | PO BOX 310502 DES MOINES, IA 50331 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 1.28% |
| MARSHALL GROUP INC4 Filed as: MARSHALL GROUP, INC. | 265 N 700 W BLACKFOOT, ID 83221 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $7K | — | $7K | 11.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $1.4M |
| INSPIRA FINANCIAL HEALTH, INC EIN 91-1774434 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | P.O. BOX 2239 OMAHA, NE 681032239 | $36K |
| AETNA BEHAVIORAL HEALTH, LLC EIN 20-0446713 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $33K |
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 | 245 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,789 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF IDAHO | 1,198 | $2.2M |
| Vision | VISION SERVICES PLAN | 1,324 | $359K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,786 | $1.5M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,783 | $1.4M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 809 | $655K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,786 | $803K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,786 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.