| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 28852 NEW YORK, NY 100878852 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $128K | — | $128K | 3.33% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $63K | $26K | $89K | 3.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $71K | $34K | $105K | 4.86% |
| WILLIS TOWERS WATSON US LLC4 Filed as: WILLIS TOWERS WATSON | PO BOX 28852 NEW YORK, NY 100878852 | TRIPLE S SALUD, INC. | $42K | — | $42K | 3.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | VISION SERVICE PLAN | $71K | — | $71K | 10.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 28852 NEW YORK, NY 10087 | KAISER PERMANENTE | $15K | — | $15K | 3.27% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | SIMNSA | $13K | — | $13K | 3.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 28852 NEW YORK, NY 10087 | HAWAII DENTAL SERVICE | $11K | — | $11K | 2.99% |
| KING, VALERIE A.3 | 406 BIG WOODS CIR BELTON, SC 29627 | PROVIDENT LIFE AND ACCIDENT INS CO AND PROVIDENT LIFE AND CASUALTY CO | $7K | — | $7K | 1.99% |
| VISUAL BENEFIT COMMUNICATIONS INC3 | STE 220 360B QUALITY CIRCLE NW HUNTSVILLE, AL 35806 | PROVIDENT LIFE AND ACCIDENT INS CO AND PROVIDENT LIFE AND CASUALTY CO | $1K | — | $1K | 0.45% |
| SWETT & CRAWFORD OF ILLINOIS, INC.3 Filed as: SWETT & CRAWFORD OF ILLINOIS INC | 14TH FL ONE N FRANKLN ST CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INS CO AND PROVIDENT LIFE AND CASUALTY CO | $1K | — | $1K | 0.37% |
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION | SYSTEMS, INC. 99 PARK AVE 25TH FL NEW YORK, NY 10016 | PROVIDENT LIFE AND ACCIDENT INS CO AND PROVIDENT LIFE AND CASUALTY CO | $1K | — | $1K | 0.31% |
| TREIMER ANN LUETTA3 Filed as: TREIMER, ANN, LUETTA | 929 ONTARIO ST OAK PARK, IL 60302 | PROVIDENT LIFE AND ACCIDENT INS CO AND PROVIDENT LIFE AND CASUALTY CO | $818 | — | $818 | 0.25% |
| WORTH, PETER, J3 | 25TH FLOOR 99 PARK AVE NEW YORK, NY 10016 | PROVIDENT LIFE AND ACCIDENT INS CO AND PROVIDENT LIFE AND CASUALTY CO | $436 | — | $436 | 0.13% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INS CO AND PROVIDENT LIFE AND CASUALTY CO | $402 | — | $402 | 0.12% |
| DREYER, DOUGLAS, PAUL3 | 13 SCHILDBACH RD POUND RIDGE, NY 10576 | PROVIDENT LIFE AND ACCIDENT INS CO AND PROVIDENT LIFE AND CASUALTY CO | $41 | — | $41 | 0.01% |
| BAGWELL, TEARLE, DAVID3 | STE 220 360B QUALITY CIRCLE HUNTSVILLE, AL 35806 | PROVIDENT LIFE AND ACCIDENT INS CO AND PROVIDENT LIFE AND CASUALTY CO | $4 | — | $4 | 0.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 100878852 | AETNA LIFE INSURANCE COMPANY | $26K | — | $26K | 9.97% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 100878852 | UNITEDHEALTHCARE INSURANCE COMPANY | $18K | — | $18K | 10.02% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 100878852 | COMBINED INSURANCE COMPANY OF NEW YORK | $10K | — | $10K | 9.78% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 100878852 | COMBINED INSURANCE COMPANY OF NEW YORK | $10K | — | $10K | 9.94% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 10087 | FIRST UNUM LIFE INSURANCE COMPANY | — | $376 | $376 | 1.11% |
| AON CONSULTING INC3 Filed as: AON HEWITT | 199 WATER ST. NEW YORK, NY 10038 | ACE AMERICAN INSURANCE COMPANY | $4K | — | $4K | 20.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $60 | $60 | 1.24% |
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)(6 contracts, 5 carriers) | HAWAI'I MEDICAL SERVICE ASSOCIATION | 52,253 | $11.6M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,477 | $5.6M |
| Vision(5 contracts, 4 carriers) | VISION SERVICE PLAN | 5,726 | $1.4M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 33,590 | $2.2M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 47 | $5K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 11,145 | $2.3M |
| Prescription drug | TRIPLE S SALUD, INC. | 237 | $1.4M |
| Other(9 contracts, 8 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 33,590 | $10.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 52,253 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.