| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CALIFORNIA PHYSICIANS' SERVICE | $426K | $19K | $445K | 2.09% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DRIVE SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $137K | — | $137K | 1.82% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $157K | $2K | $158K | 5.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DR SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $45K | — | $45K | 2.35% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET SUITE 110 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC | -$14 | — | -$14 | -0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $29K | — | $29K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COMBINED INSURANCE COMPANY OF AMERICA | $17K | $333 | $17K | 5.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 777 SOUTH FIGUEROA ST #1900 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $2K | — | $2K | 2.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DR LOS ANGELES, CA 90039 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HOLMAN FAMILY COUNSELING, INC. | $3K | — | $3K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COMBINED INSURANCE COMPANY OF AMERICA | $125 | $3 | $128 | 4.18% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | COMBINED INSURANCE COMPANY OF AMERICA | $22 | — | $22 | 4.50% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $36 | — | $36 | — |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE SUITE 1200 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4 | $4 | — |
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 | 2,665 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,690 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 3,978 | $30.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,694 | $3.2M |
| Vision(3 contracts) | COMBINED INSURANCE COMPANY OF AMERICA | 5,910 | $341K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 385 | $628K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 470 | $71K |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,911 | $417K |
| Prescription drug(4 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 3,978 | $30.8M |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,965 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,910 | — |
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.