| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $3K | $15K | 14.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $272 | $589 | $861 | 3.85% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE | $1K | $0 | $1K | 5.97% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE COMPANY | $305 | $0 | $305 | 5.21% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF OREGON | $14K | $0 | $14K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGENCE BLUECROSS BLUE SHIELD OF EIN 93-0238155 CLAIMS PROCESSING SERVICE | Float revenue; Claims processing; Direct payment from the plan Service code 12 | — | $202K |
| REGENCE BLUECROSS BLUESHIELD OF | Other commissions Service code 55 | — | $168K |
| DELTA DENTAL OF OREGON EIN 93-0438772 CLAIMS ADMINISTRATOR | Claims processing; Other commissions Service code 12 | — | $14K |
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 | 352 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 685 | $6K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE | 649 | $24K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 415 | $128K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 415 | $100K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 415 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 685 | — |
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.