| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $2K | $14K | 6.13% |
| VIRTUS LLC3 | 4550 W 109TH ST STE 301 LEAWOOD, KS 66211 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 2.64% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 306 W ERIE ST STE 300 CHICAGO, IL 60654 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 1.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 9.28% |
| HAYS COMPANIES, INC.3 | 880 APOLLO ST STE 300 EL SEGUNDO, CA 90245 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.64% |
| VIRTUS LLC3 | 9800 METCALF AVE STE 500 OVERLAND PARK, KS 66212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.36% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 8.24% |
| HAYS COMPANIES, INC.3 | 880 APOLLO ST STE 300 EL SEGUNDO, CA 90245 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.81% |
| VIRTUS LLC3 | 9800 METCALF AVE STE 500 OVERLAND PARK, KS 66212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.18% |
| VIRTUS LLC3 | 4550 W 109TH ST STE 301 OVERLAND PARK, KS 66211 | AMERITAS LIFE INSURANCE CORP. | $1K | — | $1K | 3.63% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 8.41% |
| HAYS COMPANIES, INC.3 | 880 APOLLO ST STE 300 EL SEGUNDO, CA 90245 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.84% |
| VIRTUS LLC3 | 9800 METCALF AVE STE 500 OVERLAND PARK, KS 66212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.16% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 7.95% |
| HAYS COMPANIES, INC.3 | 880 APOLLO ST STE 300 EL SEGUNDO, CA 90245 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.64% |
| VIRTUS LLC3 | 9800 METCALF AVE STE 500 OVERLAND PARK, KS 66212 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.36% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $321 | $50 | $371 | 5.69% |
| VIRTUS LLC3 | 4550 W 109TH ST STE 301 LEAWOOD, KS 66211 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $167 | — | $167 | 2.56% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 306 W ERIE ST STE 300 CHICAGO, IL 60654 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $122 | — | $122 | 1.87% |
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 | 311 | 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) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICES ASSOCIATION | 3 | $17K |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 502 | $248K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 569 | $50K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 311 | $58K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 308 | $42K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 89 | $32K |
| Prescription drug | HAWAII MEDICAL SERVICES ASSOCIATION | 3 | $17K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 311 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 569 | — |
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.