| 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 60674 | SELECT HEALTH | $34K | — | $34K | 0.73% |
| DIVERSIFIED INS BENEFITS SERVICES3 Filed as: DIVERSIFIED INS. BENEFITS SERVICES | 136 E. SOUTH TEMPLE SUITE 2300 SALT LAKE CITY, UT 841111117 | SELECT HEALTH | $24K | — | $24K | 0.52% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE SUITE 2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $2K | $5K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $450 | $4K | 4.77% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $307 | $5K | 7.75% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE SUITE 2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 4.95% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $1K | — | $1K | 3.39% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INS BENEFIT SVCS LLC | 136 E SOUTH TEMPLE SUITE 2300 SALT LAKE CITY, UT 841111117 | VISION SERVICE PLAN | $246 | — | $246 | 0.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $119 | $2K | 7.68% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE SUITE 2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $685 | $460 | $1K | 4.69% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | GUARDIAN | — | $56 | $56 | 0.26% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 1166 AVENUE OF AMERICAS NEW YORK, NY 10036 | FEDERAL INSURANCE COMPANY | $2K | — | $2K | 25.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $88 | $12 | $100 | 4.10% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE SUITE 2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $34 | $51 | $85 | 3.48% |
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 | 1,279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECT HEALTH | 1,279 | $4.7M |
| Dental | GUARDIAN | 479 | $21K |
| Vision | VISION SERVICE PLAN | 258 | $43K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 521 | $92K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 199 | $24K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 164 | $62K |
| Prescription drug | SELECT HEALTH | 1,279 | $4.7M |
| Other(2 contracts, 2 carriers) | FEDERAL INSURANCE COMPANY | 1,279 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,279 | — |
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.