| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPYREAN INSURANCE SERVICES, INC. Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 770423706 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $15K | $15K | 1.77% |
| WILLIS TOWERS WATSON US LLC7 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $5K | $5K | 0.65% |
| USI INSURANCE SERVICES LLC7 Filed as: USI INSURANCE SERVICES LL | PO BOX 66119 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $51 | $51 | 0.01% |
| EMPYREAN INSURANCE SERVICES, INC. Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 770423706 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 1.77% |
| WILLIS TOWERS WATSON US LLC7 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 0.80% |
| LIAZON BENEFITS INC5 Filed as: LIAZON BENEFITS INC. | 199 SCOTT ST FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 2.92% |
| WILLIS TOWERS WATSON US LLC3 | P.O. BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 1.67% |
| WILLIS TOWERS WATSON US LLC3 | P.O. BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $39 | $39 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 15.00% |
| EMPYREAN INSURANCE SERVICES, INC. Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 770423706 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.71% |
| WILLIS TOWERS WATSON US LLC7 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $760 | $760 | 0.61% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: ARTHUR J GALLAGHER RISK MGT SRV INC | 300 S RIVERSIDE PLAZA - FL 15TH CHICAGO, IL 60606 | ZURICH AMERICAN INSURANCE COMPANY | $5K | — | $5K | 25.00% |
| WILLIS TOWERS WATSON US LLC7 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $32 | $32 | 0.62% |
| WILLIS TOWERS WATSON US LLC7 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $56 | $56 | — |
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 | 1,619 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 49 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 22 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,690 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 787 | $497K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,619 | $846K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,619 | $0 |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,619 | $413K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 30 | $191K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 1,423 | $1.9M |
| Other(6 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,645 | $323K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,645 | — |
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."
No prospect flags tripped on this filing.