| 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 | 2.94% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S FOURTH STREET SUITE 704 LAS VEGAS, NV 89101 | BLUE CROSS OF CALIFORNIA | $34K | $0 | $34K | 5.84% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVCS. | 4851 LBJ FRWY SUITE 100 DALLAS, TX 75244 | SYMETRA LIFE INSURANCE COMPANY | $0 | $14K | $14K | 3.84% |
| 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 | $13K | $0 | $13K | 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 | $8K | $0 | $8K | 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 | $7K | $0 | $7K | 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 | $5K | $0 | $5K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $20 | $13K | 53.00% |
| 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 | 10.06% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S. 4TH STREET SUITE 700 LAS VEGAS, NC 89101 | METLIFE LEGAL PLANS | $956 | $0 | $956 | 9.97% |
| 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 | $794 | $0 | $794 | 14.99% |
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 | 450 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 219 | $1.3M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 219 | $621K |
| Vision | HAWAII MEDICAL ASSURANCE ASSOCIATION | 44 | $718K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 709 | $172K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 141 | $53K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 691 | $77K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 219 | $1.3M |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 330 | $355K |
| Other(4 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 709 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 709 | — |
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.