| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TERRY TUTTON3 | 16835 ALGONQUIN ST SUITE 407 HUNTINGTON BEACH, CA 92649 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $5K | — | $5K | 3.76% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 1120 BRISTOL ST COSTA MESA, CA 92626 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $407 | $4K | 13.70% |
| ACRISURE LLC4 Filed as: ACRISURE LLC DBA ASHTON BENEFITS | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $290 | — | $290 | 11.21% |
| NEW CHARTERS LLC4 | PO BOX 8927 ELIZABETH, NJ 07201 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $95 | — | $95 | 3.67% |
| ACRISURE LLC3 | 600 SYLVAN AVE STE 301 ENGLEWOOD CLIFFS, NJ 07632 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | — | $0 | — |
| PROFESSIONAL GROUP MARKETING INC3 | 311 CLOCK TWR COMMONS DR BREWSTER, NY 10509 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | — | $0 | — |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCE SRVCS | 311 CLOCK TOWER COMMONS DR BREWSTER, NY 10509 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | — | $0 | — |
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 | 183 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 23 | $314K |
| Dental(2 contracts, 2 carriers) | HAWAII DENTAL SERVICE | 46 | $22K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 0 | $0 |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $31K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $31K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.