| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $8K | — | $8K | 2.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CALIFORNIA PHYSICIANS' SERVICE EIN 94-0360524 NONE | Contract Administrator Service code 13 | — | $1.3M |
| DELTA DENTAL EIN 94-1461312 NONE | Contract Administrator Service code 13 | — | $174K |
| VANGUARD FIDUCIARY TRUST EIN 23-2186884 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $149K |
| THE VITA COMPANIES EIN 94-2595918 NONE | Contract Administrator Service code 13 | — | $86K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $20K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4,327 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 920 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER PERMANENTE | 1,695 | $11.2M |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 1,702 | $4.9M |
| Life insurance | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 37 | $18K |
| Prescription drug(4 contracts, 4 carriers) | KAISER PERMANENTE | 1,695 | $11.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,702 | — |
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.