| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $1K | $493 | $2K | 13.82% |
| CONNEXION INSURANCE SOLUTIONS3 | 7001 220TH ST SW MS320 MOUNTLAKE TERRAC, WA 98043 | SYMETRA LIFE INSURANCE COMPANY | $645 | — | $645 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 606945287 | VISION SERVICE PLAN | $667 | — | $667 | 8.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $74K |
| TOWERS WATSON INVESTMENT SVCS, INC. EIN 52-1868818 NONE | Direct payment from the plan; Investment management Service code 28 | — | $33K |
| BANK OF NEW YORK MELLON EIN 13-5160382 TRUSTEE | Shareholder servicing fees; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $11K |
| MOSS ADAMS LLP EIN 91-0189318 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $11K |
| USI CONSULTING GROUP, INC. EIN 06-1053228 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Direct payment from the plan; Recordkeeping fees Service code 14 | — | $10K |
| STATE STREET GLOBAL ADVSRS TRST CO EIN 81-4017137 INVESTMENT MANAGEMENT | Custodial (securities); Custodial (other than securities); Non-monetary compensation; Investment management fees paid directly by plan Service code 18 | — | $6K |
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 | 213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 140 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICES ASSOCIATION | 122 | $578K |
| Vision | VISION SERVICE PLAN | 73 | $8K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 140 | $13K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICES ASSOCIATION | 122 | $578K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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."
No prospect flags tripped on this filing.