| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62819 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $76K | $0 | $76K | 3.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | STANDARD INSURANCE COMPANY | $32K | $0 | $32K | 1.51% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $0 | $26K | $26K | 1.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $152K | $26K | $178K | 13.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $59K | $0 | $59K | 4.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $7K | $7K | 0.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNUM INSURANCE COMPANY | $23K | $7K | $30K | 10.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM INSURANCE COMPANY | $6K | $0 | $6K | 1.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $1K | $1K | 0.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 11350 MCCORMICK ROAD EXECUTIVE PLAZA III, SUITE 120 HUNT VALLEY, MD 21031 | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC, INC. | $1K | $0 | $1K | 3.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC, INC. | $444 | $0 | $444 | 1.13% |
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 | 1,630 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 41 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,699 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 12 | $126K |
| Dental(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 1,484 | $2.2M |
| Vision(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 1,484 | $2.2M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,630 | $1.3M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,630 | $1.3M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,630 | $1.3M |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 12 | $126K |
| Other(5 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,630 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,630 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.