| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CALVO'S INSURANCE UNDERWRITERS, INC3 | P.O. BOX FJ HAGATNA, GU 96932 | TOKIO MARINE PACIFIC INSURANCE LTD. | $3K | — | $3K | 2.00% |
| BUCK CONSULTANTS LLC3 Filed as: BUCK CONSULTANTS, LLC | BOX 202617 DALLAS, TX 75320 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $789 | — | $789 | 1.30% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES INC. | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | $0 | $9K | $9K | 16.75% |
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 | 4,695 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,186 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,881 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HMSA HEALTH PLAN | 118 | $758K |
| Dental | TOKIO MARINE PACIFIC INSURANCE LTD. | 21 | $147K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 4,194 | $598K |
| Life insurance | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 5,800 | $1.2M |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,047 | $632K |
| Prescription drug | TOKIO MARINE PACIFIC INSURANCE LTD. | 21 | $147K |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK | 5,037 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,800 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.