| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | HAWAII MEDICAL SERVICE ASSOCIATION | $0 | $9K | $9K | 1.66% |
| ASSUREDPARTNERS3 | 2809 EAST HARMONY ROAD, SUITE 160 FORT COLLINS, CO 80528 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | $3K | $28K | 8.74% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $745 | $2K | 0.60% |
| ASSUREDPARTNERS3 | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | $0 | $9K | 3.18% |
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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 56 | $832K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $321K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $321K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $321K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $321K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $321K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 56 | $832K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $321K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.