| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCK GLOBAL LLC3 | PO BOX 207640 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $116K | — | $116K | 17.28% |
| BUCK GLOBAL LLC3 | PO BOX 207640 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $249K | $29K | $277K | 48.89% |
| EOI SERVICE COMPANY INC3 | 1820 E 1ST STREET STE 400 SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.69% |
| WILLIS TOWERS WATSON US LLC4 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $517 | — | $517 | 0.95% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS-SAN DIEGO | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $467 | — | $467 | 0.86% |
| DAVIDSON JAMES DUNCAN3 Filed as: DAVIDSON, JAMES, D | 1820 E 1ST STREET STE 400 SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $197 | — | $197 | 0.36% |
| DAVIDSON JAMES DUNCAN3 Filed as: DAVIDSON, JAMES, DUNCAN | 1820 E 1ST STREET STE 400 SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.09% |
| PIERCE, DWIGHT, L3 Filed as: PIERCE, DWIGHT L | CO/ BENEFITS TECHNOLOGIES - DIV 15 20 WIGHT AVE STE 160 COCKEYSVILLE, MD 21030 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL DR STE 4500 HUNT VALLEY, MD 21031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
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 | 9,175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 268 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,443 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 76 | $448K |
| Short-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 2,337 | $669K |
| Other(3 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 2,337 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,337 | — |
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.