| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98011 | KAISER FOUNDATION HEALTH PLAN, INC. | $28K | $0 | $28K | 3.68% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 755 WEST BIG BEAVER ROAD SUITE 2300 TROY, MI 48084 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | $0 | $7K | 0.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98011 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $14K | $0 | $14K | 10.72% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | PO BOX 12748 ROANOKE, VA 24028 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.39% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 755 WEST BIG BEAVER ROAD SUITE 200 TROY, MI 48084 | HAWAII DENTAL SERVICE | $138 | $0 | $138 | 0.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98011 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.90% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 33213 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | VISION SERVICE PLAN | $203 | $0 | $203 | 1.10% |
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 | 208 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 121 | $1.7M |
| Dental | HAWAII DENTAL SERVICE | 275 | $89K |
| Vision | VISION SERVICE PLAN | 155 | $18K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 208 | $129K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 208 | $129K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 208 | $129K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 121 | $1.7M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 208 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.