| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $59K | — | $59K | 3.19% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNIVERSITY HEALTH ALLIANCE | $37K | — | $37K | 2.55% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $8K | — | $8K | 3.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $341 | $8K | 10.47% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $317 | $7K | 10.49% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | $22 | $2K | 19.50% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $253 | $8 | $261 | 15.50% |
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 | 484 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 487 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 300 | $3.3M |
| Dental(2 contracts, 2 carriers) | HAWAII DENTAL SERVICE | 632 | $288K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 300 | $3.3M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 484 | $65K |
| Short-term disability | AFLAC | 19 | $9K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 458 | $72K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 300 | $3.3M |
| Other(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 484 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 632 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.