| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $10K | $0 | $10K | 1.42% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET, 14TH FLOOR HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $2K | $0 | $2K | 0.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | HAWAII DENTAL SERVICE | $4K | $0 | $4K | 0.63% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO EMPLOYEE BENEFITS CONSULTING | 700 BISHOP STREET, SUITE 1400 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $3K | $0 | $3K | 0.46% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET, SUITE 1400 HONOLULU, HI 96813 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $0 | $15K | 2.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $64 | $8K | 1.96% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET, SUITE 1400 HONOLULU, HI 96813 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $18 | $4K | 1.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $793 | $793 | 0.20% |
| RITA S. ORNELLAS3 | 95-1023 HOAILONA STREET MILILANI, HI 96789 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $7 | $1K | 6.54% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET HONOLULU, HI 96813 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $576 | $0 | $576 | 3.01% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $151 | $0 | $151 | 0.79% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $93 | $53 | $146 | 0.76% |
| BELLA NATION BENEFITS LLC3 Filed as: BELLA NATION BENEFITS, LLC | 8693 TARA HILL AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $73 | $0 | $73 | 0.38% |
| CHRISTINA D POLK INC3 Filed as: CHRISTINA D. POLK, INC. | 9755 QUENCIA COURT LAS VEGAS, NV 89149 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.14% |
| CA INS. ADVOCATES AND VARIOUS AGENT3 Filed as: CA INS. ADVOCATES & OTHER AGENTS | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $6 | $23 | 0.12% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET, SUITE 1400 HONOLULU, HI 96813 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 14.92% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO EMPLOYEE BENEFITS CONSULTING | 700 BISHOP STREET SUITE 1400 HONOLULU, HI 96813 | VISION SERVICE PLAN | $559 | $0 | $559 | 2.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE SUITE 200 BELLEVUE, WA 98004 | VISION SERVICE PLAN | $508 | $0 | $508 | 2.72% |
| RITA S. ORNELLAS3 | 95-1023 HOAILONA STREET MILILANI, HI 96789 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $8 | $1K | 13.39% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET HONOLULU, HI 96813 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $474 | $0 | $474 | 6.09% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $105 | $63 | $168 | 2.16% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 2984O NETWORK PLACE CHICAGO, IL 60673 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $43 | $0 | $43 | 0.55% |
| BELLA NATION BENEFITS LLC3 Filed as: BELLA NATION BENEFITS, LLC | 8693 TARA HILL AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $30 | $0 | $30 | 0.39% |
| CALIFORNIA INSURANCE ADVOCATES INC3 Filed as: CALIFORNIA INSURANCE ADVOCATES, INC | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $7 | $26 | 0.33% |
| CHRISTINA D POLK INC3 Filed as: CHRISTINA D. POLK, INC. | 9755 QUENCIA COURT LAS VEGAS, NV 89149 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.10% |
| RITA S. ORNELLAS3 | 95-1023 HOAILONA STREET MILILANI, HI 96789 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $294 | $1 | $295 | 6.12% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET HONOLULU, HI 96813 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $132 | $0 | $132 | 2.74% |
| BELLA NATION BENEFITS LLC3 Filed as: BELLA NATION BENEFITS, LLC | 8693 TARA HILL AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | 0.68% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $5 | $13 | 0.27% |
| CHRISTINA D POLK INC3 Filed as: CHRISTINA D. POLK, INC. | 9755 QUENCIA COURT LAS VEGAS, NV 89149 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.19% |
| CALIFORNIA INSURANCE ADVOCATES INC3 Filed as: CALIFORNIA INSURANCE ADVOCATES, INC | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.06% |
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 | 290 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 294 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 758 | $4.5M |
| Dental | HAWAII DENTAL SERVICE | 882 | $623K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 758 | $3.8M |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 815 | $904K |
| Long-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 815 | $904K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 758 | $4.5M |
| Other(7 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 815 | $955K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 882 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.