Form 5500 · Employee benefit plan · INDEPENDENCE, OH
MEDIQUANT-PRO LLC
The filing calls this plan MEDIQUANT-PRO LLC MEDICAL PLAN.
MEDIQUANT-PRO LLC of INDEPENDENCE, OH insures health, vision and life coverage for its employees, per Schedule A of its Form 5500. Its broker of record is WILLIAM H HERTZOG. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 83-1244756 · plan 502 · plan year 2023, filed Jul 12, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 4 insured contracts covering health, vision and life; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 414 people.
The filing declares health, vision, life and dental. Dental appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $3,330,522, with $21,358 in disclosed broker commissions — about 0.6% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
WILLIAM H HERTZOG is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | Life | 62 | Jan 1, 2024 | $80,876 | $15,434 |
| DELTA DENTAL OF OHIO | Vision | 409 | Jan 1, 2024 | $34,486 | $3,171 |
| DELTA DENTAL OF OHIO | Vision | 397 | Jan 1, 2024 | $134,475 | $2,753 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Health | 414 | Jan 1, 2024 | $3,080,685 | $0 |
Premium and claims on these contracts
DELTA DENTAL OF OHIO, contract V10681. For the contract year on this filing, the carrier reported $34,352 in premium earned and $19,082 in claims incurred. Dividing one by the other gives 56%.
DELTA DENTAL OF OHIO, contract 0010681. For the contract year on this filing, the carrier reported $99,659 in premium earned and $98,266 in claims incurred. Dividing one by the other gives 99%.
- DELTA DENTAL OF OHIO, contract V10681 reported $9,046 in retention.
- DELTA DENTAL OF OHIO, contract 0010681 reported $16,214 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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