| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CALIFORNIA PHYSICIANS' SERVICE | $70K | — | $70K | 2.76% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DR STE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $37K | — | $37K | 1.83% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE CO. | $30K | $7K | $37K | 8.59% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $38 | $16K | 10.08% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 1.77% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5 | $5 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $2K | — | $2K | 3.15% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $4K | — | $4K | 14.59% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $268 | $5K | 21.20% |
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 | 749 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 755 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 427 | $4.6M |
| Dental | AETNA LIFE INSURANCE CO. | 1,005 | $427K |
| Vision | VISION SERVICE PLAN | 624 | $67K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 917 | $161K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 917 | $161K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 427 | $4.5M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 917 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,005 | — |
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.