| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 111 SW COLUMBIA ST SUITE 500 PORTLAND, OR 97201 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $25K | $22K | $46K | 2.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 6.34% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFEMAP ASSURANCE COMPANY | $4K | — | $4K | 7.16% |
| LONG TERM CARE SOLUTIONS, INC.3 Filed as: LONG TERM CARE SOLUTIONS | 14715 NE 95TH STREET SUITE 200 REDMOND, WA 98052 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | $482 | $6K | 24.00% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 26 | $1.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 27 | $107K |
| Vision | VISION SERVICE PLAN | 10 | $14K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 11 | $57K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 11 | $57K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 11 | $57K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 26 | $1.8M |
| Other(3 contracts, 3 carriers) | LIFEMAP ASSURANCE COMPANY | 355 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 355 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.