| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | HAWAII DENTAL SERVICE | $10K | $0 | $10K | 1.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | SYMETRA LIFE INSURANCE COMPANY | $54K | $0 | $54K | 10.00% |
| CONNEXION INSURANCE SOLUTIONS3 | 7001 220TH STREET SW, MAIL STOP 320 MOUNTLAKE TERRACE, WA 98043 | SYMETRA LIFE INSURANCE COMPANY | $27K | $0 | $27K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $0 | $13K | $13K | 2.46% |
| RITA S. ORNELLAS3 | 95-1023 HOAILONA STREET MILILANI, HI 96789 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $46 | $3K | 8.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $418 | $15 | $433 | 1.11% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET HONOLULU, HI 96813 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $375 | $0 | $375 | 0.96% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $323 | $0 | $323 | 0.83% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PALCE CHICAGO, IL 60673 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $188 | $0 | $188 | 0.48% |
| TAMMY V. THOMPSON AND OTHER AGENTS3 | 8693 TARA HILL AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $163 | $0 | $163 | 0.42% |
| JOLIE ANN SAM3 | 91-1290 KANEONEO STREET KAPOLEI, HI 96707 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $82 | $1 | $83 | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 14.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $6K | $0 | $6K | 30.63% |
| RITA S. ORNELLAS3 | 95-1023 HOAILONA STREET MILILANI, HI 96789 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $767 | $13 | $780 | 8.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $219 | $7 | $226 | 2.32% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET HONOLULU, HI 96813 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $157 | $0 | $157 | 1.61% |
| JOLIE ANN SAM3 | 91-1290 KANEONEO STREET KAPOLEI, HI 96707 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $124 | $1 | $125 | 1.28% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $64 | $0 | $64 | 0.66% |
| TAMMY V. THOMPSON AND OTHER AGENTS3 | 8693 TARA HILL AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $60 | $0 | $60 | 0.62% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PALCE CHICAGO, IL 60673 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $53 | $0 | $53 | 0.54% |
| RITA S. ORNELLAS3 | 95-1023 HOAILONA STREET MILILANI, HI 96789 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $676 | $4 | $680 | 7.79% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $84 | $0 | $84 | 0.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $36 | $1 | $37 | 0.42% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET HONOLULU, HI 96813 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.19% |
| TAMMY VAN HOUTEN-THOMPSON3 | 8693 TARA HILL AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.05% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $24 | $24 | 0.69% |
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 | 500 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 502 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 761 | $5.8M |
| Dental | HAWAII DENTAL SERVICE | 822 | $838K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 761 | $5.1M |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 502 | $542K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 502 | $542K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 761 | $5.8M |
| Other(7 contracts, 5 carriers) | SYMETRA LIFE INSURANCE COMPANY | 502 | $641K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 822 | — |
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.