| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY, LLC | PO BOX 350 CONSHOHOCKEN, PA 19428 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $20K | $20K | 0.40% |
| INNOVATE WORKPLACE BENEFITS3 | UNKNOWN FORT LAUDERDALE, FL 33312 | ZURICH INSURANCE COMPANY | $40K | $0 | $40K | 9.00% |
| ACI3 | UNKNOWN FORT LAUDERDALE, FL 33312 | ZURICH INSURANCE COMPANY | $27K | $0 | $27K | 6.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY, LLC | 9850 NW 41ST STREET SUITE 100 MIAMI, FL 33178 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $7K | $7K | 3.32% |
| BENEFIT TECHNOLOGY RESOURCES3 Filed as: BENEFIT TECHNOLOGY RESOURCES, LLC | 6230 FAIRVIEW ROAD SUITE 210 CHARLOTTE, NC 28210 | STANDARD INSURANCE COMPANY | $0 | $2K | $2K | 1.09% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $5K | $5K | 6.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY, LLC | 9850 NW 41ST STREET STE 100 MIAMI, FL 33178 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $3K | $3K | 3.39% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY, LLC | 9171 TOWNE CENTRE DRIVE SUITE 100 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | $0 | $1K | 3.29% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY, LLC | 9850 NW 41ST STREET SUITE 100 MIAMI, FL 33178 | PREFERRED LEGAL PLAN | $3K | — | $3K | 20.47% |
| THE PARTNERS GROUP3 Filed as: PARTNERS GROUP, LTD. | 11850 SW 67TH AVENUE SUITE 100 PORTLAND, OR 97223 | USABLE LIFE | $104 | — | $104 | 14.63% |
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 | 439 | 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) | 439 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 407 | $5.0M |
| Dental(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 18 | $128K |
| Vision(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 4,070 | $171K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 439 | $293K |
| Short-term disability | USABLE LIFE | 8 | $711 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 439 | $202K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 407 | $4.9M |
| Other(6 contracts, 6 carriers) | ZURICH INSURANCE COMPANY | 501 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,070 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.