| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $54K | — | $54K | 4.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC | $26K | — | $26K | 2.30% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4 EMBARCADERO CTR STE 400 SAN FRANCISCO, CA 941114156 | UNITEDHEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 3.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 911026030 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 1.45% |
| CLAREMONT BUSINESS GROUP3 Filed as: CLAREMONT BUSINESS GROUP INC | 1000 BURNETT AVE STE 440 CONCORD, CA 945202088 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 0.59% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES B OSWALD CO | 1100 SUPERIOR AVE SUITE 1500 CLEVELAND, OH 44114 | DELTA DENTAL OF CALIFORNIA | $16K | — | $16K | 10.00% |
| BRITTANY LLOYD3 | PO BOX 4942 EL DORADO HILLS, CA 95762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $4K | $8K | 13.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY INSURANCE BROKERS | PO BOX 6030 PASADENA, CA 91102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $269 | $6K | 9.83% |
| CASEY JAMES KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $862 | $2K | $3K | 5.02% |
| STEPHANIE NOELLE KUGLER3 | 906 HAWKS FEATHER LANE ROCKLIN, CA 95765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $448 | $2K | 2.76% |
| BRIAN ROBERT LLOYD3 | PO BOX 11 KNIGHTSEN, CA 94548 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $469 | $860 | $1K | 2.31% |
| SALVADOR HEREDIA3 | 700 EL COMINITO LIVERMORE, CA 94550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $854 | $163 | $1K | 1.77% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVE SAN MATEAO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $787 | $25 | $812 | 1.41% |
| LORRIE ANN RODRIGUEZ3 | 6505 N CORNELIA AVE FRESNO, CA 93722 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $298 | — | $298 | 0.52% |
| ROSA MURILLO PUENTE3 | 6143 UTE DR SAN JOSE, CA 95123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $179 | $45 | $224 | 0.39% |
| CANDICE ELISE EUSEBIO3 | 124 AMBERSTONE LANE SAN RAMON, CA 94582 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $211 | $12 | $223 | 0.39% |
| CATHERINE LISA LUKE3 | 4787 W HACIENDA AVE CAMPBELL, CA 95008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $108 | $74 | $182 | 0.32% |
| ABRAMS MARKETING INC3 | 9538 W PICO BLVD LOS ANGELES, CA 90035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $106 | $5 | $111 | 0.19% |
| DEBORAH LYNN WELLS3 | 5809 MARK TWAIN AVE SACRAMENTO, CA 95820 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | $10 | $90 | 0.16% |
| PROSESSION INC3 | 950 UNIVERSITY PARK LOOP N RENO, NV 89512 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $10 | $35 | 0.06% |
| LISA MARIE THOMAS3 | 1975 BRUCE RD 205 CHICO, CA 95928 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.06% |
| BARRY W MAAS3 | PO BOX 5809 FRESNO, CA 93755 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $8 | $22 | 0.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD #100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $968 | $3K | 7.71% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $830 | $830 | 2.51% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.23% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD #100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $826 | $2K | 7.77% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $708 | $708 | 2.57% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | ONE INVESTORS WAY NORWOOD, MA 02062 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $33 | $1K | 5.76% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD STE 100 PASADENA, CA 91102 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $672 | — | $672 | 3.22% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD #100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $486 | $298 | $784 | 7.72% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $255 | $255 | 2.51% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $988 | — | $988 | 10.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E FOOTHILL BLVD #100 PASADENA, CA 91107 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $439 | $277 | $716 | 7.53% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $238 | $238 | 2.50% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 199 | $1.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 251 | $161K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 112 | $21K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 114 | $95K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 114 | $68K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $33K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 114 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.