| 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 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $388K | — | $388K | 3.93% |
| MARSH & MCLENNAN AGENCY LLC5 Filed as: MARSH USA, INC. | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 100362774 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $94K | $94K | 0.95% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AETNA LIFE INSURANCE COMPANY | $66K | — | $66K | 5.03% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $31K | — | $31K | 3.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD ACCIDENT AND LIFE INSURANCE COMPANY | $28K | — | $28K | 5.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $18K | $25K | 10.87% |
| USI INSURANCE SERVICES LLC7 Filed as: USI INSURANCE SERVICES NA | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $11K | $13K | 14.75% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $309 | — | $309 | 3.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA US HEALTH CARE EIN 06-6033492 CONTRACT ADMINISTRATION | Contract Administrator; Direct payment from the plan Service code 13 | — | $6.0M |
| EXPRESS SCRIPTS EIN 22-3461740 CLAIMS PROCESSING | Claims processing Service code 12 | — | $1.6M |
| VIRGIN PULSE EIN 20-2547480 CONSULTANT | Claims processing Service code 12 | — | $796K |
| GROUND ROUND INC. EIN 45-3580052 CONSULTANT | Contract Administrator Service code 13 | — | $593K |
| MERCER EIN 34-2015463 CONSULTANT | Participant communication; Direct payment from the plan; Contract Administrator Service code 13 | — | $570K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 CLAIMS ADMIN | Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $522K |
| RX SAVINGS SOLUTIONS EIN 26-3642434 CONSULTANT | Contract Administrator Service code 13 | — | $399K |
| HEADSPACE CONSULTANT | Contract Administrator Service code 13 | 2415 MICHIGAN AVENUE SANTA MONICA, CA 90404 | $217K |
| WAGEWORKS, INC. EIN 20-0198855 COBRA ADMINSTRATION | Claims processing; Direct payment from the plan Service code 12 | — | $188K |
| BUDCO EIN 38-1622051 CONSULTANT | Claims processing Service code 12 | — | $115K |
| ELLIOTT DAVIS, LLC EIN 57-0381582 ACCOUNTING | Direct payment from the plan; Consulting fees Service code 50 | — | $68K |
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 CONSULTANT | Contract Administrator Service code 13 | — | $64K |
| CLICK THERAPUTICS EIN 45-5061643 CONSULTANT | Other fees Service code 99 | — | $50K |
| SAN FRANCISCO CITY OPTION OTHER | Other fees Service code 99 | P.O. BOX 194367 SAN FRANCISCO, CA 94119 | $25K |
| US BANK NATIONAL ASSOCIATION EIN 31-0841368 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $8K |
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 CLAIMS ADMIN | Participant communication; Contract Administrator; Claims processing Service code 12 | — | $6K |
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 | 29,509 | 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) | 29,509 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 463 | $3.8M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 5,608 | $5.1M |
| Life insurance(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 51,561 | $15.6M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 315 | $10K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 13,079 | $1.0M |
| Other(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 30,091 | $4.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 51,561 | — |
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.