| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS DBA BENEFITMALL | 4851 LBJ FRWY SUITE 100 DALLAS, TX 75244 | SYMETRA LIFE INSURANCE COMPANY | $0 | $17K | $17K | 2.44% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT | 300 SOUTH 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $15K | $0 | $15K | 2.99% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S FOURTH STREET SUITE 704 LAS VEGAS, NV 89101 | BLUE CROSS OF CALIFORNIA | $2K | $0 | $2K | 5.60% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 11.68% |
| CUSTOM BENEFIT CONSULTANTS INC.3 | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 891016023 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.51% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NC 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS, INC. | 300 S. 4TH STREET SUITE 700 LAS VEGAS, NC 89101 | METLIFE LEGAL PLANS | $1K | $0 | $1K | 9.96% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $448 | $0 | $448 | 14.99% |
| CUSTOM BENEFIT CONSULTANTS INC.3 Filed as: CUSTOM BENEFIT CONSULTANTS | 300 S 4TH STREET SUITE 700 LAS VEGAS, NV 89101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $235 | $0 | $235 | 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 | 662 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 664 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 172 | $545K |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 177 | $59K |
| Vision | HAWAII MEDICAL ASSURANCE ASSOCIATION | 82 | $498K |
| Life insurance(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 669 | $79K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 129 | $29K |
| Long-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 90 | $26K |
| Prescription drug | HAWAII MEDICAL ASSURANCE ASSOCIATION | 82 | $498K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 360 | $690K |
| Other(9 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 669 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 669 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.