| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $394K | — | $394K | 3.42% |
| MARSH & MCLENNAN AGENCY LLC5 Filed as: MARSH USA, INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $203K | $203K | 1.76% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $37K | — | $37K | 0.61% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE COMPANY | $69K | — | $69K | 5.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | 1350 TREAT BLVD, STE 550 WALNUT CREEK, CA 94597 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $27K | $17K | $44K | 4.92% |
| USI INSURANCE SERVICES LLC7 Filed as: USI INSURANCE SERVICES NA | 1350 TREAT BLVD, STE 550 WALNUT CREEK, CA 94597 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $8K | $24K | 4.51% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | MONUMENTAL LIFE INSURANCE COMPANY | $27K | — | $27K | 5.34% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $374 | — | $374 | 0.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA US HEALTH CARE EIN 06-6033492 CONTRACT ADMINISTRATION | Contract Administrator; Direct payment from the plan Service code 13 | — | $4.8M |
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 CLAIMS ADMINISTRATOR | Participant communication; Claims processing; Contract Administrator Service code 12 | — | $3.7M |
| EXPRESS SCRIPTS EIN 22-3461740 CLAIMS PROCESSING | Claims processing Service code 12 | — | $1.4M |
| LIMEADE, INC. EIN 06-1771116 CONSULTING | Consulting fees; Direct payment from the plan; Employee (plan) Service code 30 | — | $1.2M |
| MERCER EIN 34-2015463 CONSULTANT | Contract Administrator; Direct payment from the plan; Participant communication Service code 13 | — | $708K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 CLAIMS ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | — | $471K |
| GROUND ROUND INC. EIN 45-3580052 CONSULTANT | Contract Administrator Service code 13 | — | $468K |
| RX SAVINGS SOLUTIONS EIN 26-3642434 CONSULTANT | Contract Administrator Service code 13 | — | $377K |
| HEADSPACE CONSULTANT | Contract Administrator Service code 13 | 2415 MICHIGAN AVENUE SANTA MONICA, CA 90404 | $216K |
| WAGEWORKS INC. EIN 20-0198855 COBRA ADMINSTRATION | Direct payment from the plan; Claims processing Service code 12 | — | $181K |
| HEALTH ADVOCATE EIN 23-3080019 CONTRACT ADMINISTRATION | Participant communication; Contract Administrator; Direct payment from the plan Service code 13 | — | $130K |
| BUDCO EIN 38-1622051 CONSULTANT | Claims processing Service code 12 | — | $108K |
| CLICK THERAPUTICS EIN 45-5061643 CONSULTANT | Other fees Service code 99 | — | $48K |
| ELLIOTT DAVIS, LLC EIN 57-0381582 ACCOUNTING | Direct payment from the plan; Consulting fees Service code 50 | — | $9K |
| SAN FRANCISCO CITY OPTION OTHER | Other fees Service code 99 | P.O. BOX 194367 SAN FRANCISCO, CA 94119 | $9K |
| US BANK NATIONAL ASSOCIATION EIN 31-0841368 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $8K |
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 | 27,369 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 27,369 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 448 | $3.3M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 5,646 | $4.6M |
| Life insurance(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 47,897 | $17.3M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 193 | $62K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 12,291 | $6.1M |
| Other(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 27,925 | $5.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 47,897 | — |
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."
No prospect flags tripped on this filing.