| 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 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 1.13% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $0 | $4K | $4K | 1.05% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | HARTFORD LIFE AND ACCIDENT | $627 | $0 | $627 | 0.18% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED HEALTHCARE INSURANCE COMPANY | $15K | $0 | $15K | 5.20% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | UNITED HEALTHCARE INSURANCE COMPANY | $14K | $0 | $14K | 4.77% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED | $3K | $0 | $3K | 3.08% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | EYEMED | $2K | $0 | $2K | 1.62% |
| BENEFITSTORE INC3 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9K | $0 | $9K | 12.56% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9K | $0 | $9K | 12.46% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 310502 DES MOINES, IA 50331 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 8.94% |
| BENEFITSTORE INC3 | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 8.93% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | METLIFE LEGAL PLANS | $2K | $0 | $2K | 5.58% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METLIFE LEGAL PLANS | $1K | $278 | $2K | 5.19% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES EIN 41-1289245 CLAIMS PROCESSPR | Other services; Claims processing Service code 12 | — | $547K |
| AETNA ;IFGE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $39K |
| MERCER HEALTH & BENEFITS EIN 34-2015463 BROKER | Other commissions Service code 55 | — | $24K |
| DIVERSIFIED INSURANCE GROUP EIN 20-4442550 BROKER | Other commissions Service code 55 | — | $22K |
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 | 780 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 780 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED | 1,540 | $113K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 780 | $346K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 780 | $346K |
| Other(6 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 1,778 | $801K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,778 | — |
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.