| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 111 SW COLUMBIA STREET, SUITE 500 PORTLAND, OR 97201 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $0 | $1K | $1K | 0.10% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC. | 111 SW COLUMBIA STREET, SUITE 500 PORTLAND, OR 97201 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $0 | $656 | $656 | 0.05% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | WILLAMETTE DENTAL INSURANCE, INC. | $1K | $0 | $1K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $82 | $82 | 1.56% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC. | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $302 | $161 | $463 | 10.48% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $346 | $0 | $346 | 7.83% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $133 | $218 | 4.93% |
| MELISSA CATHLEEN HADLOCK3 | 14912 NE 249TH STREET BATTLE GROUND, WA 98604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $154 | $17 | $171 | 3.87% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | $37 | $135 | 3.05% |
| ROXANA BUSCHMAN3 Filed as: ROXANA BUSCHMAN AND OTHER AGENTS | 400 NE 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $25 | $86 | 1.95% |
| SUSAN J LEACH3 | 4419 NE 131ST PLACE APARTMENT C1 PORTLAND, OR 97230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | $3 | $85 | 1.92% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $63 | $63 | 1.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $17 | $17 | 1.59% |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 216 | $1.4M |
| Dental(2 contracts, 2 carriers) | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 167 | $114K |
| Vision | REGENCE BLUECROSS BLUESHIELD OF OREGON | 216 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 36 | $5K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 37 | $4K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 37 | $5K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 216 | $1.4M |
| Other(3 contracts, 3 carriers) | CASCADE CENTERS, INC. DBA CANOPY WELLBEING | 200 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 216 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.