| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS AND COMP. SYSTEMS | 99 PARK AVENUE, SUITE 2500 NEW YORK, NY 10168 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $82K | $0 | $82K | 5.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE NEW YORK, NY 10177 | AETNA LIFE INSURANCE COMPANY | $0 | $44 | $44 | 0.02% |
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS AND COMP. SYSTEMS | 99 PARK AVENUE, 25TH FLOOR NEW YORK, NY 10016 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $891 | $8K | 13.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $366 | $3K | 4.32% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $2K | $2K | 2.55% |
| ALLIANT INSURANCE SERVICES, INC.3 | UNKNOWN NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $1K | $1K | 1.82% |
| ERIC LEVY3 | 99 PARK AVENUE, 25TH FLOOR NEW YORK, NY 10016 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $726 | $726 | 1.23% |
| AGNES D. NINES3 | 31 EAST BUTLER AVENUE, 1ST FLOOR AMBLER, PA 19002 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $250 | $0 | $250 | 0.42% |
| JEFFREY JOSEPH JONES3 | 99 PARK AVENUE, 25TH FLOOR NEW YORK, NY 10016 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $35 | $0 | $35 | 0.06% |
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS AND COMP. SYSTEMS | 99 PARK AVENUE, 25TH FLOOR NEW YORK, NY 10016 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $941 | $150 | $1K | 13.58% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $302 | $302 | 3.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $150 | $146 | $296 | 3.69% |
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 | 3,109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 66 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $14K |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 697 | $206K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,810 | $1.5M |
| Long-term disability(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,810 | $1.6M |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $14K |
| Other(5 contracts, 5 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 4,627 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,627 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.