| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNIVERSITY HEALTH ALLIANCE | $30K | — | $30K | 2.78% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $26K | — | $26K | 3.51% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $3K | — | $3K | 2.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $33 | $2K | 10.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE, SUITE 350 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6967 S RIVER GATE DR STE 200 MIDVALE, UT 84047 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $195 | $195 | 1.28% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | $76 | $2K | 11.39% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $40 | $1K | 15.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE, SUITE 350 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $299 | $299 | 3.50% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $50 | $1 | $51 | 10.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE, SUITE 350 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $50 | — | $50 | 10.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6967 S RIVER GATE DR STE 200 MIDVALE, UT 84047 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $6 | $6 | 1.21% |
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 | 331 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 332 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNIVERSITY HEALTH ALLIANCE | 185 | $1.8M |
| Dental | HAWAII DENTAL SERVICE | 339 | $127K |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 185 | $1.8M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 233 | $15K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 31 | $9K |
| Prescription drug(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 185 | $1.8M |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 340 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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.