| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN, INC. | $86K | — | $86K | 3.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 731739 DALLAS, TX 75373 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $253K | — | $253K | 12.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SRVS WEST | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $25K | $25K | 1.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN, INC. | $30K | — | $30K | 3.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | ONE BUSH ST 9TH FLOOR SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $19K | — | $19K | 3.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $12K | — | $12K | 3.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $10K | — | $10K | 3.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $9K | — | $9K | 3.35% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21K | $8K | $29K | 18.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 250 MONROE AVENUE NW SUITE 400 GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. | $2K | $350 | $2K | 4.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 38 EAST WOOD DRIVE SUITE 300 SOUTH BURLINGTON, VT 05403 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 3.27% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | THE PAUL REVERE LIFE INSURANCE COMPANY | $207 | $90 | $297 | 51.03% |
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 | 3,112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 140 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(11 contracts, 9 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 299 | $5.4M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 49 | $319K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 49 | $319K |
| Life insurance(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,128 | $2.2M |
| Short-term disability(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,128 | $2.2M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,128 | $2.1M |
| Prescription drug(9 contracts, 7 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 299 | $5.2M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,128 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,128 | — |
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.