| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNIVERSITY HEALTH ALLIANCE | $36K | — | $36K | 3.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $10K | $54 | $10K | 3.09% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET, SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $4K | — | $4K | 3.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 125 OTTAWA AVE NW SUITE 400 CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 11.47% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $94 | $94 | 0.09% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $842 | — | $842 | 6.14% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET SUITE 1100 HONOLULU, HI 96813 | WORKLIFE HAWAII | $203 | — | $203 | 3.00% |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 232 | $1.5M |
| Dental | HAWAII DENTAL SERVICE | 347 | $119K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 141 | $325K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 252 | $105K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 252 | $105K |
| Prescription drug(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 232 | $1.5M |
| Other(6 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 398 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 398 | — |
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.