| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $16K | $16K | 1.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | METROPOLITAN LIFE INSURANCE COMPANY | -$7K | $118 | -$7K | -0.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $6K | $0 | $6K | 1.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVEUE, WA 98004 | TOKIO MARINE PACIFIC INSURANCE, LTD. | $0 | $8K | $8K | 3.00% |
| CALVO'S INSURANCE UNDERWRITERS, INC3 | PO BOX FJ HAGATNA, GU 96932 | TOKIO MARINE PACIFIC INSURANCE, LTD. | $5K | $0 | $5K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 18.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 15.00% |
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 | 1,204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 349 | $4.2M |
| Dental | AETNA LIFE INSURANCE COMPANY | 5 | $34K |
| Vision(5 contracts, 5 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 679 | $4.0M |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,098 | $1.5M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,098 | $1.5M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,098 | $1.5M |
| Prescription drug(5 contracts, 5 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 349 | $4.2M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,098 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,098 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.