| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 155 N WACKER DR STE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC. | $156K | — | $156K | 1.61% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET, STE 2400 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC. | $31K | $6K | $37K | 0.38% |
| MERCER HEALTH AND BENEFITS, LLC3 | 27647 NETWORK PLACE CHICAGO, IL 60673 | BLUE CROSS OF CALIFORNIA | $7K | — | $7K | 0.48% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 101809 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $3K | $3K | 0.41% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$13 | $263 | $250 | 0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | — | $16K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 155 N WACKER DR STE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 2.18% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET, STE 2400 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC. | — | $115 | $115 | 0.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 5.00% |
| EOI SERVICE COMPANY INC5 Filed as: EOI SERVICE CO, INC. | 1820 E 1ST STREET SUITE 400 SANTA ANA, CA 92705 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.85% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| EOI SERVICE COMPANY INC5 Filed as: EOI SERVICE CO, INC. | 1820 E 1ST STREET SUITE 400 SANTA ANA, CA 92705 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.61% |
| INTEGRO INSURANCE BROKERS3 | P.O. BOX 101809 PASADENA, CA 91189 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 6.03% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 1.88% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $949 | — | $949 | 1.37% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $270 | — | $270 | 5.00% |
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 | 819 | 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) | 823 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,422 | $11.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,670 | $779K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 2,502 | $70K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 792 | $358K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $5K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $21K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,422 | $11.5M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 792 | $586K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,502 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.