| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 N MICHIGAN AVE 15TH FLOOR CHICAGO, IL 60611 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $96K | $2K | $98K | 2.45% |
| PAUL FLOTKEN3 | 701 MARKET STREET STE 1000 ST LOUIS, MO 63101 | HARVARD PILGRIM HEALTH CARE | $51K | — | $51K | 1.55% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST #900 KANSAS CITY, MO 64112 | HARVARD PILGRIM HEALTH CARE | $231 | — | $231 | 0.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5482 WILSHIRE BLVD STE 1566 LOS ANGELES, CA 90036 | HARTFORD LIFE AND ACCIDENT | $14K | $94K | $108K | 7.98% |
| ACRISURE LLC7 Filed as: ACRISURE OF CALIFORNIA LLC | 5482 WILSHIRE BLVD STE 1566 LOS ANGELES, CA 90036 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $51K | $59K | 7.36% |
| PAUL FLOTKEN3 | 701 MARKET STREET STE 1000 ST LOUIS, MO 63101 | HARVARD PILGRIM HEALTH CARE | $4K | — | $4K | 1.91% |
| ACRISURE LLC7 Filed as: ACRISURE OF CALIFORNIA LLC | 5482 WILSHIRE BLVD STE 1566 LOS ANGELES, CA 90036 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $13K | $16K | 7.02% |
| ACRISURE LLC7 Filed as: ACRISURE OF CALIFORNIA, LLC | 5482 WILSHIRE BLVD STE 1566 LOS ANGELES, CA 90036 | AETNA INTERNATIONAL | $1K | — | $1K | 0.82% |
| ACRISURE LLC7 Filed as: ACRISURE OF CALIFORNIA LLC | 5482 WILSHIRE BLVD STE 1566 LOS ANGELES, CA 90036 | CIGNA LIFE INSURANCE CO OF NEW YORK | $0 | $867 | $867 | 4.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATOR | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Other services; Contract Administrator; Direct payment from the plan Service code 12 | — | $57.5M |
| LOCKTON COMPANIES LLC EIN 20-3395470 ACTUARY | Consulting (general); Actuarial Service code 11 | — | $190K |
| CONDUENT CONSULTING ACTUARY | Consulting (general); Actuarial Service code 11 | 100 CAMPUS DRIVE SUITE 200 FLORHAM PARK, NJ 07932 | $48K |
| BANK OF NEW YORK MELLON EIN 13-5160382 INVESTMENT SERVICES | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $47K |
| BUCK GLOBAL, LLC EIN 13-3954297 ACTUARY | Consulting (general); Actuarial Service code 11 | — | $30K |
| HALEY & ASSOCIATES, LLC EIN 55-0810153 AUDIT | Accounting (including auditing) Service code 10 | — | $14K |
| BROWN SMITH WALLACE LLP EIN 43-1001367 TAX PREP | Accounting (including auditing) Service code 10 | — | $8K |
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 | 9,351 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 58 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,409 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(10 contracts, 7 carriers) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 11,773 | $37.1M |
| Dental(5 contracts, 3 carriers) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 11,773 | $20.9M |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 11,456 | $4.7M |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 13,508 | $1.5M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 10,139 | $806K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 11,773 | $11.3M |
| Other(7 contracts, 7 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 38,538 | $7.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 38,538 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.