| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 2121 N CALIFORNIA BLVD WALNUT CREEK, CA 94596 | AETNA LIFE INSURANCE COMPANY | $198K | $0 | $198K | 4.99% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $58K | $0 | $58K | 5.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $754 | $754 | 0.07% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 100 PINE STREET 11TH FLOOR SAN FRANCISCO, CA 94111 | PRINCIPAL LIFE INSURANCE COMPANY | $52K | $0 | $52K | 5.95% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 0.45% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $39K | $0 | $39K | 4.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $563 | $563 | 0.07% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 2185 NORTH CALIFORNIA BLVD SUITE 400 WALNUT CREEK, CA 94596 | HOMETOWN HEALTH | $27K | $0 | $27K | 3.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVENUE NE SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $2K | $0 | $2K | 2.24% |
| D A FINANCIAL INSURANCE SVCS INC3 | 3470 MT DIABLO BLVD SUITE A100 LAFAYETTE, CA 94549 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $54 | $0 | $54 | 3.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 21ST FL TWO PIERCE PL ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10 | $0 | $10 | 0.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD 5TH FL 11TH FLOOR ROLLING MEADOW, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 1.21% |
| D A FINANCIAL INS SERVICES INC3 | 3470 MOUNT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94549 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $1 | $1 | 0.08% |
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 | 869 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 882 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 426 | $8.1M |
| Dental(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 194 | $1.5M |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 194 | $1.5M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,017 | $870K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,017 | $870K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,017 | $870K |
| Prescription drug(6 contracts, 4 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 194 | $4.1M |
| Other(3 contracts, 3 carriers) | WEST HEALTH ADVOCATE SOLUTIONS, INC. | 801 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,017 | — |
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.