| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $22K | $0 | $22K | 3.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $10K | $0 | $10K | 2.96% |
| ASSUREDPARTNERS3 | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $1K | $0 | $1K | 0.41% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET, SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $2K | $0 | $2K | 2.53% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 12.51% |
| ASSUREDPARTNERS3 | 1873 SOUTH BELLAIRE STREET SUITE 600 DENVER, CO 80222 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 3.96% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $28 | $28 | 0.05% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $14 | $14 | 0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $76 | $4K | 14.71% |
| ASSUREDPARTNERS3 | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $25 | $1K | 4.61% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $512 | $43 | $555 | 16.25% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $69 | $0 | $69 | 3.06% |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 105 | $1.1M |
| Dental | HAWAII DENTAL SERVICE | 220 | $77K |
| Vision | HAWAII MEDICAL ASSURANCE ASSOCIATION | 105 | $721K |
| Life insurance(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 145 | $84K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 145 | $55K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 105 | $1.1M |
| Other(4 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 145 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.