| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $39K | $39K | 1.40% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | UNIMERICA LIFE INSURANCE COMPANY | $105K | — | $105K | 7.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $20K | — | $20K | 2.86% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2520 NORTHWINDS PARKWAY SUITE 600 ALPHARETTA, GA 30009 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $28K | — | $28K | 5.45% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | AETNA LIFE INSURANCE CO. | — | $3K | $3K | 0.60% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $29K | $5K | $34K | 8.17% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $5K | — | $5K | 2.86% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | HARTFORD LIFE AND ACCIDENT | $581 | $58 | $639 | 16.49% |
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 | 3,062 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,078 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 7 carriers) | HIGHMARK BLUE CROSS BLUE SHIELD | 1,708 | $12.1M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 21 | $142K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 3,220 | $536K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 5,105 | $2.8M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 5,105 | $2.8M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 5,105 | $2.8M |
| Prescription drug | HIGHMARK BLUE CROSS BLUE SHIELD | 1,708 | $8.6M |
| Stop-loss / reinsurancereinsurance | UNIMERICA LIFE INSURANCE COMPANY | 1,276 | $1.5M |
| Other(4 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 5,105 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,105 | — |
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."
No prospect flags tripped on this filing.