| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 111 SW COLUMBIA ST #500 PORTLAND, OR 97201 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $52K | $780 | $53K | 3.17% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $6K | — | $6K | 4.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $281 | $3K | 9.10% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $182 | $2K | 8.83% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $175 | $2K | 9.14% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN, LLC | PO BOX 310502 DES MOINES, IA 50331 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7K | — | $7K | 57.14% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $1K | $80 | $1K | 11.97% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $195 | $21 | $216 | 9.55% |
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 | 165 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 230 | $1.7M |
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 263 | $138K |
| Vision | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 230 | $1.7M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 153 | $21K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 153 | $31K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 153 | $19K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 230 | $1.7M |
| Other(3 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 153 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 263 | — |
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.