| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNIVERSITY HEALTH ALLIANCE | $27K | — | $27K | 2.72% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $12K | — | $12K | 3.53% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $2K | — | $2K | 2.00% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $3K | — | $3K | 18.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | DBA INSURANCE POINT AGENCY, LLC 181 E 5600 S, STE 240 SALT LAKE CITY, UT 84107 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 12.07% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.83% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $781 | $36 | $817 | 11.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | DBA INSURANCE POINT AGENCY, LLC 181 E 5600 S,STE 240 SALT LAKE CITY, UT 84107 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $273 | $273 | 3.79% |
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 | 324 | 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) | 324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNIVERSITY HEALTH ALLIANCE | 223 | $1.3M |
| Dental | HAWAII DENTAL SERVICE | 315 | $110K |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 223 | $1.3M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 243 | $13K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 29 | $7K |
| Prescription drug(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 223 | $1.3M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 275 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.