| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 0.73% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $280 | $280 | 0.13% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $767 | $767 | 0.72% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $140 | $140 | 0.13% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $229 | $229 | 0.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $39 | $39 | 0.13% |
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 | 751 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 765 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 4 | $31K |
| Vision | VISION SERVICE PLAN | 461 | $80K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 751 | $212K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 630 | $106K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 274 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 751 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.