| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE, 3RD FLOOR NEW YORK, NY 10177 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $49K | $0 | $49K | 3.29% |
| AMERICAN BENEFITS AND COMPENSATION3 | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $31K | $0 | $31K | 2.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE, 3RD FLOOR NEW YORK, NY 10177 | AETNA LIFE INSURANCE COMPANY | $0 | $23 | $23 | 0.01% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFIT LLC | 1166 AVENUE OF AMERICAS, SUITE 22F NEW YORK, NY 10036 | FEDERAL INSURANCE COMPANY | $6K | $0 | $6K | 25.00% |
| AMERICAN BENEFITS AND COMPENSATION3 | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $481 | $3K | 15.43% |
| ERIC LEVY3 | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $386 | $0 | $386 | 1.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $176 | $0 | $176 | 0.83% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | -$460 | -$460 | -2.17% |
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 | 3,267 | 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) | 3,267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $15K |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 742 | $193K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,925 | $1.5M |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,925 | $1.5M |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $15K |
| Other(5 contracts, 5 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,925 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,925 | — |
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.