| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $38K | $38K | 2.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 5 CONCOURSE PKWY NE STE 1800 ATLANTA, GA 30328 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $37K | — | $37K | 2.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $963 | $963 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 905643 CHARLOTTE, NC 28290 | RELIASTAR LIFE INSURANCE COMPANY | $242K | $3K | $245K | 28.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | HEARST TOWER 214 N TRYON ST STE 2500 CHARLOTTE, NC 28202 | AMERITAS LIFE INSURANCE CORP. | — | $12K | $12K | 1.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29727 NETWORK PL CHICAGO, IL 60673 | METLIFE LEGAL PLANS | $9K | — | $9K | 7.89% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | METLIFE LEGAL PLANS | $3K | $522 | $4K | 3.39% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | 1 UPPER POND RD BLDG F PARSIPPANY, NJ 07054 | METLIFE LEGAL PLANS | — | $132 | $132 | 0.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WATSON WYATT & COMPANY | 901 N. GLEBE ROAD ARLINGTON, VA 22203 | METLIFE LEGAL PLANS | — | $132 | $132 | 0.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | 29727 NETWORK PL CHICAGO, IL 60673 | METLIFE LEGAL PLANS | — | $126 | $126 | 0.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 200 LIBERTY STREET STE 300 NEW YORK, NY 10281 | ACE AMERICAN INSURANCE COMPANY | $24K | — | $24K | 25.00% |
| AON CONSULTING INC3 | ONE LIBERTY PLAZA 165 BROADWAY STE 3201 NEW YORK, NY 10006 | ACE AMERICAN INSURANCE COMPANY | $9K | — | $9K | 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 | 3,993 | 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) | 3,993 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 4 | $48K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 875 | $136K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 6,182 | $621K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,037 | $1.8M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,993 | $781K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 4 | $48K |
| Other(6 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,446 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,182 | — |
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.