| 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 | — | $30K | $30K | 2.25% |
| 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 | $26K | — | $26K | 2.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $666 | $666 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $461 | $461 | 0.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 905643 CHARLOTTE, NC 28290 | RELIASTAR LIFE INSURANCE COMPANY | $117K | — | $117K | 22.27% |
| 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 | 3.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | BROOKFIELD PLACE, 200 LIBERTY STREE NEW YORK, NY 10281 | ACE AMERICAN INSURANCE COMPANY | $24K | — | $24K | 25.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METLIFE LEGAL PLANS | $8K | — | $8K | 9.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WATSON WYATT & COMPANY | 901 N. GLEBE ROAD ARLINGTON, VA 22203 | METLIFE LEGAL PLANS | — | $3K | $3K | 3.37% |
| MERCER HEALTH AND BENEFITS, LLC3 | PO BOX 100260 PASADENA, CA 91189 | METLIFE LEGAL PLANS | — | $777 | $777 | 0.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 5420 LYNDON B JOHNSON FWY STE 400 DALLAS, TX 75240 | METLIFE LEGAL PLANS | — | $149 | $149 | 0.18% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 1166 AVENUE OF THE AMERICAS FL 9 NEW YORK, NY 10036 | METLIFE LEGAL PLANS | — | $1 | $1 | 0.00% |
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 | 2,714 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 116 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 69 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,899 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $42K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 483 | $81K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 1,863 | $372K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,659 | $1.3M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,714 | $674K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $42K |
| Other(5 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,714 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,714 | — |
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.