| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT | 300 SOUTH 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $21K | $0 | $21K | 3.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 7660 W CHEYENNE SUITE 109 LAS VEGAS, NV 89129 | BLUE CROSS OF CALIFORNIA | $36K | $0 | $36K | 5.26% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVCS. | DBA BENEFITMALL 2111 E HIGHLAND AVE., SUITE B210 PHOENIX, AZ 85016 | HCC LIFE INSURANCE COMPANY | $20K | $0 | $20K | 5.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $10K | $0 | $10K | 10.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 704 LAS VEGAS, NC 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $0 | $6K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $47 | $47 | 0.18% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.73% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S. 4TH STREET SUITE 700 LAS VEGAS, NC 89101 | HYATT LEGAL PLANS | $572 | $0 | $572 | 6.08% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S. 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | HYATT LEGAL PLANS | $365 | $143 | $508 | 5.40% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 704 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $560 | $0 | $560 | 15.01% |
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 | 699 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 707 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 281 | $1.4M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 281 | $734K |
| Vision | HAWAII MEDICAL ASSURANCE ASSOCIATION | 115 | $705K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 682 | $139K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 140 | $42K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 691 | $62K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 281 | $1.4M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 370 | $399K |
| Other(4 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 682 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 691 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.