| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $71K | $27K | $98K | 5.97% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | SUN LIFE ASSURANCE COMPANY OF CANADA | $32K | — | $32K | 6.44% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD OF MINNESOTA | PO BOX 64560 ST. PAUL, MN 55164 | FOUR EVER LIFE INS CO | — | $1K | $1K | 4.00% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD OF MINNESOTA | PO BOX 64560 ST. PAUL, MN 55164 | FOUR EVER LIFE INS CO | — | $973 | $973 | 4.00% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $484 | $151 | $635 | 5.25% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $393 | $123 | $516 | 5.25% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | FIRST UNUM LIFE INSURANCE COMPANY | $305 | $106 | $411 | 5.39% |
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 | 2,090 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,995 | $316K |
| Vision | VISION SERVICE PLAN | 1,628 | $195K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,151 | $1.6M |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 44 | $30K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,151 | $1.6M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,794 | $500K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,151 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,151 | — |
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."
No prospect flags tripped on this filing.