| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $290 | $290 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 1.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 1.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 12505 PARK POTOMAC AVENUE SUITE 300 POTOMAC, MD 20854 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | — | $4K | $4K | 1.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | ARAG INSURANCE COMPANY | $6K | — | $6K | 13.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS, INC. | 3010 BRIARPARK DRIVE STE 8000 HOUSTON, TX 77042 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $941 | $941 | 2.73% |
| HEALTH ADVOCATE SOLUTIONS, INC.3 | 721 ARBOR WAY SUITE 150 BLUE BELL, PA 19422 | HEALTH ADVOCATE SOLUTIONS, INC. | — | $16K | $16K | 45.94% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSHPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $16 | $10K | 30.05% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS, INC. | 3010 BRIARPARK DRIVE STE 8000 HOUSTON, TX 77042 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $534 | $534 | 2.74% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS, INC. | 3010 BRIARPARK DRIVE STE 8000 HOUSTON, TX 77042 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $397 | $397 | 2.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 2010 MAIN ST SUITE 1050 IRVINE, CA 92614 | AETNA INTERNATIONAL | $170 | — | $170 | 8.50% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2 | $2 | — |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $8 | $8 | — |
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 | 1,406 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,456 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,512 | $18.5M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 4 | $53K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 4 | $53K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,406 | $610K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,406 | $465K |
| Prescription drug(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,512 | $18.6M |
| Other(11 contracts, 6 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,406 | $326K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,512 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.