| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4445 EASTGATE MALL SUITE 300 SAN DIEGO, CA 92121 | UNITEDHEALTHCARE INSURANCE COMPANY | $65K | — | $65K | 3.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNITEDHEALTHCARE INSURANCE COMPANY | $14K | — | $14K | 0.82% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR. CHICAGO, IL 606740001 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 1.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | DELTA DENTAL OF CALIFORNIA | $876 | — | $876 | 0.46% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $10K | 7.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.13% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR. CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $909 | $12K | 17.38% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | — | $200 | $200 | 0.39% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | ADMINISTRATION LLC P.O. BOX 310502 DES MOINES, IA 503310502 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $664 | $9K | 27.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $39 | $3K | 9.59% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | ADMINISTRATION LLC P.O. BOX 310502 DES MOINES, IA 503310502 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $597 | $6K | 27.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $39 | $1K | 6.88% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | ALLSTATE BENEFITS 4565 PAYSPHERE CIR. CHICAGO, IL 606740001 | U.S. LEGAL SERVICES OF WISCONSIN, INC. | $3K | — | $3K | 19.36% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR. CHICAGO, IL 606740001 | VISION SERVICE PLAN | $834 | — | $834 | 5.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 911076024 | VISION SERVICE PLAN | $178 | — | $178 | 1.17% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE | $1K | $11 | $1K | 8.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | EYEMED VISION CARE | $97 | — | $97 | 0.78% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR. CHICAGO, IL 606740001 | DELTA DENTAL OF CALIFORNIA | $95 | — | $95 | 1.40% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | DELTA DENTAL OF CALIFORNIA | $29 | — | $29 | 0.43% |
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 | 346 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 216 | $2.4M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 439 | $199K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 175 | $28K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $188K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $120K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $120K |
| Prescription drug(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 216 | $2.4M |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $258K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 439 | — |
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.