| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $25 | $1K | 10.21% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $603 | $603 | 5.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE, STE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $13 | $13 | 0.11% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $932 | $74 | $1K | 10.79% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $466 | $466 | 5.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE, STE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $37 | $37 | 0.40% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $782 | $35 | $817 | 10.45% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $391 | $391 | 5.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE, STE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $17 | $17 | 0.22% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $138 | $12 | $150 | 10.89% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $69 | $69 | 5.01% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE, STE 1950 ATLANTA, GA 90339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6 | $6 | 0.44% |
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 | 111 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HAWAII MEDICAL SERVICE ASSOCIATION | 59 | $610K |
| Dental(2 contracts) | HAWAII MEDICAL SERVICE ASSOCIATION | 59 | $610K |
| Vision(2 contracts) | HAWAII MEDICAL SERVICE ASSOCIATION | 59 | $610K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $12K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $8K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $9K |
| Prescription drug(2 contracts) | HAWAII MEDICAL SERVICE ASSOCIATION | 59 | $610K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.