| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $35K | $4K | $39K | 15.75% |
| RUEBEN WARNER ASSOCIATES, INC.3 Filed as: RUEBEN WARNER AND ASSOCIATES | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 17.00% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 15.00% |
| CLEARPOINT, LLC3 | 720 OLIVE WAY, SUITE 1700 SEATTLE, WA 98101 | MANAGED HEALTH NETWORK | $554 | — | $554 | 5.00% |
| ELIZABETH M RIEN4 Filed as: ELIZABETH M. RIEN | 5939 YORKSHIRE DRIVE PARADISE, CA 95969 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $791 | — | $791 | 11.19% |
| CLEARPOINT, LLC4 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $230 | — | $230 | 3.25% |
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 | 340 | 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) | 340 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 1 | $5K |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 1 | $5K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 1 | $5K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 113 | $250K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 113 | $245K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 113 | $245K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 1 | $5K |
| Other(5 contracts, 5 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 340 | $283K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.