| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | $0 | $7K | 4.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 203 N LA SALLE STREET FLOOR 20 CHICAGO, IL 60601 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | $0 | $7K | 4.49% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | SUN LIFE ASSURANCE COMPANY OF CANADA | $15K | $3K | $18K | 14.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 3510 N CAUSEWAY BLVD STE 300 METAIRIE, LA 70002 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $0 | $5K | 3.70% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 155 N WACKER DR STE 1500 CHICAGO, IL 606061710 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 4.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN INC | $982 | $0 | $982 | 1.45% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 155 N WACKER DR STE 1500 CHICAGO, IL 606061710 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | $0 | $1K | 3.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 E JACKSON BLVD CHICAGO, IL 606044466 | KAISER FOUNDATION HEALTH PLAN, INC. | $406 | $0 | $406 | 1.19% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | SUN LIFE ASSURANCE COMPANY OF CANADA | $167 | $50 | $217 | 12.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 3510 N CAUSEWAY BLVD STE 300 METAIRIE, LA 70002 | SUN LIFE ASSURANCE COMPANY OF CANADA | $20 | $0 | $20 | 1.11% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $22 | $55 | $77 | 9.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | PO BOX 2158 RIVERSIDE, CA 92516 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $2 | $0 | $2 | 0.25% |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 7 | $102K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 121 | $147K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 121 | $147K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 137 | $124K |
| Short-term disability(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 137 | $127K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 137 | $124K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 7 | $102K |
| Other(4 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 137 | $227K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.