| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 155 NORTH WACKER DRIVE SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC. | $177K | $0 | $177K | 2.15% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | $0 | $5K | 0.07% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNION SECURITY INSURANCE COMPANY | $33K | $0 | $33K | 8.29% |
| HIXME INSURANCE SOLUTIONS, INC.3 Filed as: HIXME INSURANCE SOLUTIONS INC. | 27489 AGOURA ROAD, SUITE 100 AGOURA HILLS, CA 91301 | UNION SECURITY INSURANCE COMPANY | $3K | $0 | $3K | 0.71% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $0 | $10K | 9.94% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UDC DENTAL OF CALIFORNIA, INC. | $7K | $0 | $7K | 9.15% |
| HIXME INSURANCE SOLUTIONS, INC.3 Filed as: HIXME INSURANCE SOLUTIONS INC. | 27489 AGOURA ROAD, SUITE 100 AGOURA HILLS, CA 91301 | UDC DENTAL OF CALIFORNIA, INC. | $555 | $0 | $555 | 0.72% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 777 SOUTH FIGUEROA ST. SUITE 1900 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 9.43% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HOLMAN FAMILY COUNSELING, INC. | $615 | $0 | $615 | 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 | 902 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 912 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 1,613 | $8.2M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 267 | $472K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 358 | $30K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,162 | $97K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 1,613 | $8.2M |
| Other | HOLMAN FAMILY COUNSELING, INC. | 1,301 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,613 | — |
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.