| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE, SUITE 200 BELLEVUE, WA 98004 | METROPOLITAN LIFE INSURANCE COMPANY | $43K | $82 | $43K | 2.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | — | $22K | $22K | 1.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $7K | — | $7K | 1.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | TOKIO MARINE PACIFIC INSURANCE LTD. | $7K | — | $7K | 3.00% |
| CALVOS INSURANCE UNDERWRITERS, INC.3 | PO BOX FJ HAGATNA, GU 96932 | TOKIO MARINE PACIFIC INSURANCE LTD. | $5K | — | $5K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | VISION SERVICE PLAN | $2K | — | $2K | 2.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 19.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $890 | $890 | 1.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENFIT SERVICES, INC. | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNITED HEALTHCARE OF CALIFORNIA | $121 | — | $121 | 0.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 501 FELLOWSHIP ROAD, SUITE 201 MOUNT LAUREL, NJ 08054 | AETNA INTERNATIONAL | $1K | — | $1K | 11.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $25 | $25 | — |
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 | 1,064 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 442 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,506 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 448 | $4.6M |
| Dental | AETNA INTERNATIONAL | 1 | $9K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 600 | $91K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,019 | $1.5M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,019 | $1.5M |
| Prescription drug(6 contracts, 6 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 448 | $4.6M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,019 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,019 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.