| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92506 | HEALTH NET | $55K | — | $55K | 1.53% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HEALTH NET | — | $28K | $28K | 0.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | PO BOX 2158 RIVERSIDE, CA 925162158 | KAISER FOUNDATION HEALTH PLAN INC. | $43K | $6K | $49K | 1.71% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN INC. | $22K | — | $22K | 0.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $7K | — | $7K | 1.95% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $855 | $577 | $1K | 0.42% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 6.65% |
| THOMAS P. FREISMUTH3 | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 6.59% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK | 2122 KRATKY ROAD ST. LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 6.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | SIMNSA HEALTH PLAN - MEXICAN HMO | $5K | — | $5K | 4.68% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | SIMNSA HEALTH PLAN - MEXICAN HMO | $3K | — | $3K | 2.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 4.65% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL MIDWEST LIMITED | 55 E JACKSON SUITE 148 CHICAGO, IL 60604 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | — | $1K | $1K | 1.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | VISION SERVICE PLAN | $2K | — | $2K | 2.79% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $392 | — | $392 | 0.70% |
| VARIOUS - SEE ATTACHMENT3 Filed as: VARIOUS- SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $3K | — | $3K | 17.13% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4445 EASTGATE MALL SUITE 300 SAN DIEGO, CA 92121 | HEALTH AND HUMAN RESOURCES CENTER, INC. | $655 | — | $655 | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | HYATT LEGAL PLANS, INC. | $583 | $95 | $678 | 6.36% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HYATT LEGAL PLANS, INC. | $387 | $39 | $426 | 3.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSTITY AVENUE SUITE 300 RIVERSIDE, CA 92501 | HYATT LEGAL PLANS, INC. | $194 | — | $194 | 1.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | HYATT LEGAL PLANS, INC. | — | $38 | $38 | 0.36% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | PO BOX 100260 RIVERSIDE, CA 91189 | HYATT LEGAL PLANS, INC. | — | $20 | $20 | 0.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 7770 JEFFERSON NE SUITE 101 ALBUQUERQUE, NM 87109 | HYATT LEGAL PLANS, INC. | — | $19 | $19 | 0.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 2262 CARMEL VALLEY ROAD DEL MAR, CA 92014 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $150 | — | $150 | 15.00% |
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 | 626 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 633 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | HEALTH NET | 557 | $6.6M |
| Dental | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | 904 | $342K |
| Vision | VISION SERVICE PLAN | 275 | $56K |
| Life insurance | STANDARD LIFE INSURANCE COMPANY | 574 | $114K |
| Short-term disability | AFLAC | 18 | $17K |
| Long-term disability | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 593 | $85K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 557 | $6.4M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 626 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 904 | — |
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.