| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 PASADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN INC | $42K | $0 | $42K | 1.35% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST FL 6 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $3K | $3K | 0.09% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $41K | $0 | $41K | 2.51% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92102 | FOUR EVER LIFE INS CO | $6K | $0 | $6K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SERVICES INC | 580 CALIFORNIA STREET SUITE 1300 SAN FRANCISCO, CA 94104 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA. | $4K | $0 | $4K | 15.00% |
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 | 2,502 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 40 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,547 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 601 | $3.1M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 5 | $25K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 5 | $25K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,478 | $1.7M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,478 | $1.7M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 601 | $3.1M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,478 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,478 | — |
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.