| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $26K | $26K | 0.73% |
| LOCKTON COMPANIES, LLC3 | 751 ARBOY WAY, SUITE 250 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $11K | $11K | 0.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $119K | $156 | $119K | 13.70% |
| LOCKTON COMPANIES, LLC3 | 1185 AVENUE OF THE AMERICAS SUITE 2010 NEW YORK, NY 10036 | METROPOLITAN LIFE INSURANCE COMPANY | $32K | $174 | $32K | 3.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $7K | $7K | 0.85% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.23% |
| LOCKTON COMPANIES, LLC3 | ONE INTERNATIONAL PLACE, 16TH FLOOR BOSTON, MA 02110 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY INSURANCE CO. | $25K | $0 | $25K | 3.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METLIFE LEGAL PLANS | $10K | $0 | $10K | 5.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | METLIFE LEGAL PLANS | $9K | $217 | $9K | 4.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | METLIFE LEGAL PLANS | $0 | $2K | $2K | 0.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 12750 MERIT DRIVE, SUITE 10000 DALLAS, TX 75251 | METLIFE LEGAL PLANS | $2K | $0 | $2K | 0.83% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | METLIFE LEGAL PLANS | $0 | $653 | $653 | 0.33% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 200 EAST RANDOLPH STREET CHICAGO, IL 60601 | METLIFE LEGAL PLANS | $0 | $7 | $7 | 0.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES & OTHER AGENTS | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METLIFE LEGAL PLANS | $0 | $6 | $6 | 0.00% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 58 | $383K |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 58 | $383K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY INSURANCE CO. | 12,208 | $1.1M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 6,863 | $3.5M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 6,863 | $3.5M |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 58 | $383K |
| Other(5 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 6,863 | $4.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,208 | — |
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."
Final-filing indicator set. Plan is winding down; don't waste sales effort here.