| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNIVERSITY HEALTH ALLIANCE | $73K | — | $73K | 2.94% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET, SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $6K | — | $6K | 2.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $4K | — | $4K | 1.29% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $5K | $110 | $5K | 10.67% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON RD COLUMBUS, GA 31999 | AFLAC | $2K | — | $2K | 11.37% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $644 | $47 | $691 | 11.21% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $721 | — | $721 | 16.05% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET, SUITE 1100 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $180 | — | $180 | 5.01% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $189 | — | $189 | 11.12% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET, SUITE 1100 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | -$119 | — | -$119 | — |
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 | 268 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 3 carriers) | UNIVERSITY HEALTH ALLIANCE | 369 | $2.8M |
| Dental(5 contracts, 2 carriers) | HAWAII DENTAL SERVICE | 522 | $365K |
| Vision(6 contracts, 3 carriers) | UNIVERSITY HEALTH ALLIANCE | 369 | $2.8M |
| Life insurance(5 contracts, 2 carriers) | AFLAC | 94 | $77K |
| Short-term disability(4 contracts) | AFLAC | 71 | $73K |
| Long-term disability | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 79 | $0 |
| Prescription drug(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 369 | $2.8M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 107 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 522 | — |
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.