| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 5100 SW MACADAM STE 440 PORTLAND, OR 97239 | PROVIDENCE HEALTH PLAN | $15K | — | $15K | 1.74% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENCE HEALTH PLAN | $15K | — | $15K | 1.72% |
| HEFFERNAN INSURANCE BROKERS3 | 5 HANOVER SQUARE 22ND FLOOR NEW YORK, NY 10004 | THE GUARDIAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 4.66% |
| MERCER HEALTH AND BENEFITS, LLC3 | ONE INVESTORS WAY NORWOOD, MA 02062 | THE GUARDIAN LIFE INSURANCE COMPANY | $852 | $75 | $927 | 1.03% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $268 | $2K | 6.00% |
| HEFFERNAN INSURANCE BROKERS3 Filed as: HEFFERNAN INSURANCE SERVICES | STE 440 5100 SW MACADAM AVE PORTLAND, OR 97239 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.93% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $84 | $1K | 9.11% |
| HEFFERNAN INSURANCE BROKERS3 | STE 440 5100 SW MACADAM AVE PORTLAND, OR 97239 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $786 | — | $786 | 6.59% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $706 | $59 | $765 | 9.06% |
| HEFFERNAN INSURANCE BROKERS3 | STE 440 5100 SW MACADAM AVE PORTLAND, OR 97239 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $560 | — | $560 | 6.63% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 153 | $864K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 138 | $90K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 163 | $49K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $12K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 163 | $41K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 153 | $864K |
| Other(4 contracts, 3 carriers) | PROVIDENCE HEALTH PLAN | 163 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.