| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $70K | $22K | $91K | 4.80% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $432 | $2K | 4.85% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD OF MINNESOTA | P.O. BOX 64560 ST. PAUL, MN 55164 | FOUR EVER LIFE INS CO | — | $857 | $857 | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $263 | $263 | 2.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS CORROON CORP OF NY INC | 200 LIBERTY STREET 6TH FLOOR, STE 6 NEW YORK, NY 10281 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $30 | — | $30 | 0.25% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $434 | $136 | $570 | 5.26% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $414 | $129 | $543 | 5.24% |
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 | 2,300 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 35 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 2,300 | $313K |
| Vision | VISION SERVICE PLAN | 1,804 | $220K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,538 | $1.9M |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 42 | $21K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,538 | $1.9M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,538 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,538 | — |
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.