| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEDGWICK CLAIMS MANAGEMENT SERVICES5 | 2620 THOUSAND OAKS BLVD. MEMPHIS, TN 38118 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $888K | $888K | 9.26% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 1 BEACON ST SUITE 1700 BOSTON, MA 02108 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $418K | — | $418K | 4.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | SOUTHEAST INC, 29848 NETWORK PLACE CHICAGO, IL 606731298 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $139K | — | $139K | 1.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON INS | SVCS WEST INC PO BOX 101162 PASADENA, CA 911890001 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $54K | — | $54K | 0.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 208546805 | KAISER FOUNDATION HEALTH PLAN INC. | $143K | — | $143K | 2.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 208546805 | KAISER FOUNDATION HEALTH PLAN INC. | $113K | — | $113K | 3.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20854 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $17K | — | $17K | 3.23% |
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 | 15,374 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 128 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 15,502 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 697 | $11.4M |
| Dental(3 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,799 | $2.5M |
| Vision | VISION SERVICE PLAN | 13,218 | $1.4M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 19,351 | $9.6M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 19,351 | $9.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 19,351 | $9.6M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 19,351 | $9.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 19,351 | — |
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.