| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | $0 | $38K | $38K | 1.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $0 | $560 | $560 | 0.07% |
| BENEPLACE, INC.3 | PO BOX 203550 AUSTIN, TX 78720 | METROPOLITAN LIFE INSURANCE COMPANY | $66K | $4K | $70K | 21.12% |
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 | 2,565 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 52 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,617 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 427 | $3.2M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 9 | $44K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,565 | $3.5M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 2,565 | $3.5M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,565 | $3.5M |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 427 | $3.2M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 4,539 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,539 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.