| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 2.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | — | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $6K | $6K | 2.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3000 EXECUTIVE PKWY STE 300 SAN RAMON, CA 94583 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 3.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 2.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | VISION SERVICE PLAN | -$4 | — | -$4 | -0.01% |
| USI INSURANCE SERVICES LLC3 | 12 GILL ST STE 5500 WOBURN, MA 01801 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 16.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $863 | $3K | 11.08% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $292 | $292 | 1.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3000 EXECUTIVE PKWY STE 300 SAN RAMON, CA 94583 | UNUM INSURANCE COMPANY | — | $560 | $560 | 3.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION | — | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $2K | $2K | 12.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $682 | — | $682 | 4.37% |
| USI INSURANCE SERVICES LLC3 | 12 GILL ST STE 5500 WOBURN, MA 01801 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 0.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3000 EXECUTIVE PKWY STE 300 SAN RAMON, CA 94583 | UNUM INSURANCE COMPANY | — | $345 | $345 | 2.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METLIFE LEGAL PLANS | $943 | $9 | $952 | 9.09% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3000 EXECUTIVE PKWY STE 300 SAN RAMON, CA 94583 | UNUM INSURANCE COMPANY | — | $314 | $314 | 3.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $1K | $1K | 17.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $386 | $2K | 37.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 43.65% |
| AON CONSULTING INC3 | 165 BROADWAY, SUITE 3201 NEW YORK, NY 10006 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $1K | — | $1K | 25.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 79.08% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $433 | $433 | 12.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 2.45% |
| USI INSURANCE SERVICES LLC3 | 12 GILL ST STE 5500 WOBURN, MA 01801 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 1.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3390 UNIVERSITY AVE., SUITE 300 RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $336 | — | $336 | 13.10% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $253 | $253 | 9.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 3000 EXECUTIVE PKWY STE 300 SAN RAMON, CA 94583 | FIRST UNUM LIFE INSURANCE COMPANY | — | $91 | $91 | 4.43% |
| MERCER HEALTH AND BENEFITS, LLC3 | 3475 PIEDMONT RD, NE ATLANTA, GA 30305 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $265 | $265 | 17.51% |
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 | 245 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 26 | $385K |
| Vision | VISION SERVICE PLAN | 211 | $45K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 249 | $226K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 250 | $106K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 26 | $385K |
| Other(16 contracts, 7 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 249 | $358K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.