| 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 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 0.64% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 0.64% |
| HINE, GREGORY3 | 1106 COLUMBIA MARYSVILLE, WA 98270 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 3.93% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | -$22 | $2K | 3.28% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $999 | — | $999 | 1.33% |
| PREFERRED BENEFITS LLC3 Filed as: PREFERRED BENEFITS INC. | PO BOX 5597 TWIN FALLS, ID 83303 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $444 | — | $444 | 0.59% |
| THE MEISENBACH COMPANY3 | 1325 4TH AVENUE SUITE 2100 SEATTLE, WA 98101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $253 | — | $253 | 0.34% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $225 | — | $225 | 0.30% |
| BRATRUD MIDDLETON INSURANCE BROKERS3 | PO BOX 2940 TACOMA, WA 98401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $159 | — | $159 | 0.21% |
| NICHOLS, DALE, ALLEN3 | 728 LEGENDS CREST DRIVE FRANKLIN, TN 37069 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.02% |
| SCOTT L STANDLEY3 Filed as: SCOTT, DAVID A | PO BOX 5597 TWIN FALLS, ID 83303 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $216 | $216 | 0.64% |
| HINES, GREGORY3 | 1106 COLUMBIA MARYSVILLE, WA 98270 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $321 | — | $321 | 3.17% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $226 | — | $226 | 2.23% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAG, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $87 | — | $87 | 0.86% |
| PREFERRED BENEFITS LLC3 Filed as: PREFERRED BENEFITS INC. | PO BOX 5597 TWIN FALLS, ID 83303 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.55% |
| THE MEISENBACK COMPANY3 | 1325 4TH AVENUE SUITE 2100 SEATTLE, WA 98101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.31% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.24% |
| BRATRUD MIDDLETON INSURANCE BROKERS3 | PO BOX 2940 TACOMA, WA 98401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.20% |
| NICHOLS, DALE, ALLEN3 Filed as: NICHOLS, DALE ALLEN | 728 LEGENDS CREST DRIVE FRANKLIN, TN 37069 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $73 | $79 | $152 | 1.50% |
| SPRINGBOARD BENEFITS3 Filed as: SPRINGBOARD BENEFITS, LLC | 75 5TH ST NW SUITE 2135 ATLANTA, GA 30308 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $73 | — | $73 | 0.72% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $258 | $3K | 36.16% |
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 | 2,862 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,879 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL GROUP | 895 | $422K |
| Vision | VISION SERVICE PLAN | 2,885 | $259K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,852 | $495K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,852 | $482K |
| Other(6 contracts, 4 carriers) | WELLSPRING FAMILY SERVICES, EAP | 3,033 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,033 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.