| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX 28852 PO BOX 28852 NEW YORK, NE 10087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $142K | $142K | 11.61% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | PO BOX 905494 CHARLOTTE, NC 282905494 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $53 | $53 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE RD. ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | -$38 | -$38 | -0.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $28K | — | $28K | 2.97% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $39K | — | $39K | 5.24% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PL CHICAGO, IL 606731298 | KAISER FOUNDATION HEALTH PLAN INC. | -$16K | — | -$16K | -2.13% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 143 | $1.9M |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 33 | $164K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 143 | $1.9M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,378 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,378 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.