| 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 | $71K | $21K | $91K | 7.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $31K | $0 | $31K | 8.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE, 3RD FLOOR NEW YORK, NY 10177 | AETNA LIFE INSURANCE COMPANY | $0 | $193 | $193 | 0.05% |
| AMERICAN BEN. AND COMP. SYS. INC.3 Filed as: AMERICAN BEN. AND COMP. SYSTEMS | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18K | $3K | $21K | 17.32% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 18100 VON KARMAN AVENUE 10TH FLOOR IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $6K | $6K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $432 | $0 | $432 | 0.36% |
| ERIC LEVY3 | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $215 | $0 | $215 | 0.18% |
| JEFFREY JOSEPH JONES3 | 101 PARK AVENUE, 14 FLOOR NEW YORK, NY 10178 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 1166 AVENUE OF THE AMERICAS SUITE 22F NEW YORK, NY 10036 | FEDERAL INSURANCE COMPANY | $6K | $0 | $6K | 25.00% |
| AMERICAN BEN. AND COMP. SYS. INC.3 Filed as: AMERICAN BEN. AND COMP. SYSTEMS | 101 PARK AVENUE, 14TH FLOOR NEW YORK, NY 10178 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $338 | $3K | 17.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $28 | $0 | $28 | 0.19% |
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 | 3,222 | 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) | 3,222 | 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 | 3,383 | $388K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $14K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,222 | $1.3M |
| Long-term disability(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,222 | $1.4M |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $14K |
| Other(6 contracts, 6 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,383 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,383 | — |
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.