| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC. | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | SYMETRA LIFE INSURANCE COMPANY | $139 | $44K | $44K | 2.27% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET STE 300 HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $197K | — | $197K | 22.52% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $37K | — | $37K | 4.25% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC. | 5775 EAST GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30328 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15K | — | $15K | 1.70% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 0.51% |
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 | 7,829 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,869 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 5,183 | $10.7M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $13K |
| Vision(2 contracts) | EYEMED VISION CARE ON BEHALF OF COMBINED INSURANCE COMPANY OF AMERICA | 7,836 | $417K |
| Life insurance(3 contracts, 3 carriers) | SYMETRA LIFE INSURANCE COMPANY | 6,242 | $3.3M |
| Long-term disability(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 6,242 | $2.4M |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 866 | $7.8M |
| Other(3 contracts, 3 carriers) | SYMETRA LIFE INSURANCE COMPANY | 5,183 | $2.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,836 | — |
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.