| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 0.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMERA BLUE CROSS EIN 91-0499247 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $1.7M |
| A&I BENEFIT PLAN ADMINISTRATORS INC EIN 93-0446761 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $592K |
| MODA HEALTH EIN 93-0438772 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $203K |
| MERCER HEALTH & BENEFITS, LLC. EIN 34-2015463 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $199K |
| JOSEPH REINHART NONE | Legal; Direct payment from the plan Service code 29 | 7355 SW HERMOSO WAY TIGARD, OR 97223 | $123K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $70K |
| MEDCO EIN 22-3461740 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $53K |
| US BANK N.A. EIN 31-0841368 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $51K |
| COMMUNICATION PARTNERS, INC. EIN 93-1083918 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $42K |
| VISION SERVICE PLAN EIN 91-6056925 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $39K |
| RV KUHNS & ASSOCIATES EIN 93-0901652 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $33K |
| MILLIMAN EIN 91-6575641 NONE | Actuarial Service code 11 | — | $31K |
| BMI AUDIT SERVICES LLC EIN 35-2051914 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $9K |
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 | 2,305 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,122 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,427 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 26 | $133K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 4,180 | $437K |
| Stop-loss / reinsurancereinsurance | LIFEWISE INSURANCE CO | 2,694 | $148K |
| Other | HARTFORD LIFE AND ACCIDENT | 2,844 | $393K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,180 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.