| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | P.O. BOX 4047 CONCORD, CA 94524 | BLUE CROSS OF CALIFORNIA | — | $46K | $46K | 0.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | ATTN EMP BENEFITS DEPT 55 E JACKSON BLVD #14A CHICAGO, IL 60604 | RELIASTAR LIFE INSURANCE COMPANY | $53K | — | $53K | 4.73% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | RELIASTAR LIFE INSURANCE COMPANY | $15K | — | $15K | 1.30% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 15.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | LOS CORPORATE LOCKBOX GPO BOX 27447 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 74.84% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | LOS CORPORATE LOCKBOX GPO BOX 27447 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 74.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALI | P.O. BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $28 | $28 | — |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | PO BOX 310502 DES MOINES, IA 50331 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15 | — | $15 | — |
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 | 944 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 952 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 2,276 | $15.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 2,518 | $1.2M |
| Vision | VISION SERVICE PLAN | 895 | $174K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,494 | $1.1M |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 1,494 | $1.1M |
| Long-term disability(3 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,494 | $1.1M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 2,276 | $15.4M |
| Other(5 contracts, 5 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,494 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,518 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.