| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 NEW YORK, NY 10087 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $62K | $307K | $369K | 11.33% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $651 | $651 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $0 | $345 | $345 | 0.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | UNKNOWN SAN FRANCISCO, CA 94103 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | $0 | $10K | 6.67% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | LOCKBOX 28852 NEW YORK, NY 10087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $0 | $4K | 2.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NE INC. | 200 LIBERTY STREET, 7TH FLOOR NEW YORK, NY 10281 | ZURICH AMERICAN INSURANCE COMPANY | $23K | $0 | $23K | 25.00% |
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 | 3,869 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 102 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 48 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,019 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 676 | $4.3M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 27 | $302K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 27 | $145K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,096 | $3.3M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,096 | $3.3M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,096 | $3.3M |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 676 | $4.3M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 10,369 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,369 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.