| 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 | $108K | $1K | $110K | 3.04% |
| PAUL FLOTKEN3 | 701 MARKET STREET STE 1000 ST LOUIS, MO 63101 | HARVARD PILGRIM HEALTH CARE | $55K | — | $55K | 1.79% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 6255 SUDBURY DRIVE DALLAS, TX 75214 | HARTFORD LIFE AND ACCIDENT | $17K | $33K | $50K | 3.00% |
| ACRISURE LLC7 Filed as: ACRISURE OF CALIFORNIA LLC | 6255 SUDBURY DRIVE DALLAS, TX 75214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $68K | $78K | 7.71% |
| PAUL FLOTKEN3 | 701 MARKET STREET SUITE 1000 SAINT LOUIS, MO 63101 | HARVARD PILGRIM HEALTH CARE | $23K | — | $23K | 3.40% |
| PAUL FLOTKEN3 | 701 MARKET STREET STE 1000 ST LOUIS, MO 63101 | HARVARD PILGRIM HEALTH CARE | $5K | — | $5K | 2.01% |
| ACRISURE LLC7 Filed as: ACRISURE OF CALIFORNIA LLC | 6255 SUDBURY DRIVE DALLAS, TX 75214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $8K | $10K | 5.31% |
| ACRISURE LLC7 Filed as: ACRISURE OF CALIFORNIA, LLC | 5482 WILSHIRE BLVD LOS ANGELES, CA 90036 | AETNA INTERNATIONAL | $1K | — | $1K | 0.68% |
| ACRISURE LLC7 Filed as: ACRISURE OF CALIFORNIA LLC | 6255 SUDBURY DRIVE DALLAS, TX 75214 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $927 | $9K | $10K | 12.08% |
| ACRISURE LLC7 Filed as: ACRISURE OF CALIFORNIA LLC | 6255 SUDBURY DRIVE DALLAS, TX 75214 | CIGNA LIFE INSURANCE CO OF NEW YORK | — | $3K | $3K | 6.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATOR | Non-monetary compensation; Claims processing; Other services; Float revenue; Named fiduciary; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $65.0M |
| LOCKTON COMPANIES LLC EIN 20-3395470 ACTUARY | Consulting (general); Actuarial Service code 11 | — | $152K |
| BUCK GLOBAL, LLC EIN 13-3954297 ACTUARY | Actuarial; Consulting (general) Service code 11 | — | $72K |
| BANK OF NEW YORK MELLON EIN 13-5160382 INVESTMENT SERVICES | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $46K |
| HALEY & ASSOCIATES, LLC EIN 55-0810153 AUDIT | Accounting (including auditing) Service code 10 | — | $15K |
| 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 | 9,392 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 81 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,473 | 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 | 11,945 | $38.9M |
| Dental(5 contracts, 3 carriers) | HMSA BLUE CROSS BLUE SHIELD OF HAWAII | 11,945 | $22.5M |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 12,125 | $5.2M |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 15,221 | $1.8M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 10,443 | $1.0M |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 11,945 | $11.9M |
| Other(8 contracts, 7 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 45,365 | $7.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 45,365 | — |
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.