| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNIVERSITY HEALTH ALLIANCE | $64K | — | $64K | 3.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $3K | — | $3K | 1.06% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET, SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $5K | — | $5K | 1.97% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $11K | $21 | $11K | 11.98% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET, SUITE 1100 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $1K | — | $1K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET, SUITE 1100 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $1K | — | $1K | 5.00% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON RD COLUMBUS, GA 31999 | AFLAC | $2K | — | $2K | 11.52% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $1K | — | $1K | 12.88% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.08% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $610 | $4 | $614 | 11.30% |
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 | 222 | 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) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 3 carriers) | UNIVERSITY HEALTH ALLIANCE | 300 | $2.5M |
| Dental(5 contracts, 2 carriers) | HAWAII DENTAL SERVICE | 401 | $358K |
| Vision(6 contracts, 3 carriers) | UNIVERSITY HEALTH ALLIANCE | 300 | $2.5M |
| Life insurance(5 contracts, 2 carriers) | AFLAC | 228 | $147K |
| Short-term disability(4 contracts) | AFLAC | 65 | $122K |
| Long-term disability | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 208 | $23K |
| Prescription drug(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 300 | $2.4M |
| Other(2 contracts, 2 carriers) | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 228 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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.