| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CALIFORNIA PHYSICIANS' SERVICE | $3K | — | $3K | 3.50% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $650 | $2K | 11.59% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $252 | $72 | $324 | 11.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 2610 NORTHGATE DRIVE IOWA CITY, IA 52242 | SYMETRA LIFE INSURANCE COMPANY | $255 | — | $255 | 9.98% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRLCE CHICAGO, IL 60674 | HEALTH PLAN OF NEVADA | $83 | — | $83 | 4.01% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $50 | $104 | 5.35% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.57% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES, INC | PO BOX 2158 RIVERSIDE, CA 92516 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.36% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $31 | — | $31 | 7.62% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10 | — | $10 | 2.46% |
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 | 749 | 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) | 749 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 246 | $148K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 487 | $18K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 487 | $15K |
| Life insurance | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 130 | $2K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 130 | $2K |
| Prescription drug(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 246 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 487 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.