| 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 606740045 | UNITED CONCORDIA INSURANCE COMPANY | $33K | — | $33K | 0.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 ADMIN FEES | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing; Other services Service code 12 | — | $1.4M |
| UNITED HEALTHCARE SERVICE, INC EIN 41-1289245 CLAIM PROCESSING | Claims processing; Other services Service code 12 | — | $777K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 MEDICAL FEE | Float revenue; Claims processing; Participant communication; Other services; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Contract Administrator Service code 12 | — | $405K |
| EXPRESS SCRIPTS, INC EIN 22-3461740 CONTRACT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $304K |
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 | 11,087 | 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) | 11,087 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. CALIFORNIA | 6,160 | $48.9M |
| Dental(3 contracts, 3 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 14,895 | $5.5M |
| Vision | VISION SERVICE PLAN | 7,389 | $1.3M |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. CALIFORNIA | 6,160 | $31.0M |
| Other | UNITEDHEALTHCARE OF CALIFORNIA | 1,740 | $17.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 14,895 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.