| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $36K | $7K | $43K | 1.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MATSONFORD ROAD RADNOR, PA 19087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $94K | $0 | $94K | 6.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $28K | $28K | 2.05% |
| ENCORE ADVISORS3 | UNKNOWN GREENWOOD VILLAGE, CO 80111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $27K | — | $27K | 6.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1205 WESTLAKES DRIVE, SUITE 290 BERWYN, PA 19312 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | $0 | $6K | 1.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4819 EMPEROR BOULEVARD, SUITE 200 DURHAM, NC 27703 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | $0 | $4K | 3.30% |
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 | 973 | 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) | 973 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,345 | $976K |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,027 | $2.8M |
| Vision(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,027 | $2.8M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 973 | $1.4M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 973 | $1.4M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 973 | $1.4M |
| Prescription drug(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,345 | $976K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 973 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,027 | — |
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.