| 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, NY 100878852 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $8K | $8K | 0.75% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $65K | $65K | 11.08% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 0.84% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $50 | — | $50 | 10.00% |
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 | 4,656 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 39 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,695 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 7 | $69K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $500 |
| Vision | VISION SERVICE PLAN | 3,331 | $559K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6,162 | $1.1M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,529 | $591K |
| Prescription drug | HAWAII MEDICAL ASSURANCE ASSOCIATION | 7 | $69K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 9,293 | $761K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6,162 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,293 | — |
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.