| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH RISK AND INSURANCE SERVICES | 777 S. FIGUEROA ST. LOS ANGELES, CA 90017 | CALIFORNIA PHYSICIANS' SERVICE | $113K | — | $113K | 2.75% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF CALIFORNIA | $22K | — | $22K | 5.82% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 15.35% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 15.36% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 7.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HOLMAN PROFESSIONAL COUNSELING CENTERS | $633 | — | $633 | 4.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $491 | $2 | $493 | 3.91% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $348 | $5 | $353 | 2.80% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.51% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HYATT LEGAL PLANS | $801 | $140 | $941 | 11.74% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HYATT LEGAL PLANS | — | $38 | $38 | 0.47% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $120 | — | $120 | 2.53% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $76 | — | $76 | 1.60% |
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 | 478 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 481 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 784 | $4.1M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 480 | $417K |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 784 | $4.1M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 478 | $83K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 21 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 478 | $51K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 784 | $4.1M |
| Other(3 contracts, 3 carriers) | HOLMAN PROFESSIONAL COUNSELING CENTERS | 478 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 784 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.