| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $30K | — | $30K | 0.17% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $77K | $4K | $82K | 1.95% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTHCARE OF CALIFORNIA | $103K | — | $103K | 7.07% |
| CHILD HEALTH CORP OF AMERICA3 | 6803 W 64TH ST, SUITE 208 SHAWNEE MISSION, KS 66202 | HARTFORD LIFE AND ACCIDENT | $72K | $28K | $100K | 8.78% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | — | $35K | $35K | 3.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4 EMBARCADERO CENTER, SUITE 40 SAN FRANCISCO, CA 94111 | TRANSAMERICA LIFE INSURANCE COMPANY | $104K | — | $104K | 22.15% |
| THOMPSON BOSTROM & ASSOCIATES LLC3 Filed as: THOMPSON BOSTROM AND ASSOCIATES LLC | 66 NORTH ATLANTIC AVE, STE 201 COCA BEACH, FL 32931 | TRANSAMERICA LIFE INSURANCE COMPANY | $57 | — | $57 | 0.01% |
| EXCELSIOR BENEFITS LLC3 | 23505 SMITHTOWN RD, STE 200 EXCELSIOR, MN 55331 | TRANSAMERICA LIFE INSURANCE COMPANY | $25 | — | $25 | 0.01% |
| VARIOUS - SEE ATTACHMENT3 | PO BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $102K | — | $102K | 23.66% |
| CHILD HEALTH CORP OF AMERICA3 | 6803 W 64TH ST, SUITE 208 SHAWNEE MISSION, KS 66202 | HARTFORD LIFE AND ACCIDENT | $5K | $7K | $11K | 7.84% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | — | $5K | $5K | 3.44% |
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 | 4,312 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,335 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 4,399 | $23.7M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 5,957 | $2.7M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 6,504 | $349K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 5,149 | $1.1M |
| Short-term disability | TRANSAMERICA LIFE INSURANCE COMPANY | 304 | $469K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 5,149 | $1.1M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 4,399 | $21.8M |
| Other | HARTFORD LIFE AND ACCIDENT | 4,721 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,504 | — |
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.