| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRINGE INSURANCE BENEFITS, INC.3 | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | NATIONWIDE LIFE INSURANCE COMPANY | $124K | $5K | $129K | 23.42% |
| LOCKTON COMPANIES, LLC3 | 14850 N. SCOTTSDALE RD. #225 SCOTTSDALE, AZ 85254 | NATIONWIDE LIFE INSURANCE COMPANY | — | $2K | $2K | 0.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 3.41% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 300 JERICHO QUADRANGLE JERICHO, NY 01753 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 1.97% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 173850 DEPT 999228 DENVER, CO 80217 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 1.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 3.43% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 300 JERICHO QUADRANGLE JERICHO, NY 01753 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 1.97% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 173850 DEPT 999228 DENVER, CO 80217 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $671 | — | $671 | 1.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $552 | $552 | 3.20% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 300 JERICHO QUADRANGLE JERICHO, NY 01753 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $340 | — | $340 | 1.97% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | PO BOX 173850 DEPT. 999228 DENVER, CO 80217 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $206 | — | $206 | 1.20% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $143 | — | $143 | 0.92% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 | 820 GESSNER, #1000 HOUSTON, TX 77024 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $119 | — | $119 | 0.77% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC - KANSAS CITY | 444 W. 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $107 | — | $107 | 2.26% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | PO BOX 905494 CHARLOTTE, NC 28290 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $71 | — | $71 | 1.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | PO BOX 2158 RIVERSIDE, CA 92516 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $389 | $52 | $441 | 17.01% |
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 | 514 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 518 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | NATIONWIDE LIFE INSURANCE COMPANY | 691 | $573K |
| Dental | NATIONWIDE LIFE INSURANCE COMPANY | 691 | $553K |
| Vision(4 contracts, 3 carriers) | NATIONWIDE LIFE INSURANCE COMPANY | 691 | $621K |
| Life insurance(2 contracts, 2 carriers) | NATIONWIDE LIFE INSURANCE COMPANY | 691 | $737K |
| Short-term disability | NATIONWIDE LIFE INSURANCE COMPANY | 691 | $553K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 499 | $58K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 3 | $20K |
| Other(3 contracts, 2 carriers) | NATIONWIDE LIFE INSURANCE COMPANY | 691 | $573K |
| 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.