| 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 | $9K | $0 | $9K | 1.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | SYMETRA LIFE INSURANCE COMPANY | $63K | $0 | $63K | 10.00% |
| CONNEXION INSURANCE SOLUTIONS3 | 7001 220TH STREET SW, MS320 MOUNTLAKE TERRACE, WA 98043 | SYMETRA LIFE INSURANCE COMPANY | $31K | $0 | $31K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | $0 | $7K | $7K | 1.15% |
| RITA S. ORNELLAS3 | 95-1023 HOAILONA STREET MILILANI, HI 96789 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $55 | $3K | 7.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $735 | $55 | $790 | 1.84% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET HONOLULU, HI 96813 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $366 | $0 | $366 | 0.85% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $326 | $1 | $327 | 0.76% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $151 | $0 | $151 | 0.35% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.10% |
| TAMMY V. THOMPSON AND OTHER AGENTS3 Filed as: TAMMY V.THOMPSON AND OTHER AGENTS | 8693 TARA HILL AVENUE LAS VEGAS, NV 89418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $1K | $0 | $1K | 6.97% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF HAWAII, INC. | 700 BISHOP STREET, SUITE 1400 HONOLULU, HI 96813 | VISION SERVICE PLAN | -$258 | $0 | -$258 | -1.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | -$5K | $0 | -$5K | -24.37% |
| RITA S. ORNELLAS3 | 95-1023 HOAILONA STREET MILILANI, HI 96789 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $429 | $0 | $429 | 4.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $202 | $0 | $202 | 2.15% |
| 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 | 1.67% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $30 | $0 | $30 | 0.32% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.27% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $0 | $19 | 0.20% |
| TAMMY V. THOMPSON AND OTHER AGENTS3 | 8693 TARA HILL AVENUE LAS VEGAS, NV 89418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.03% |
| RITA S. ORNELLAS3 | 95-1023 HOAILONA STREET MILILANI, HI 96789 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $337 | $1 | $338 | 6.27% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $1 | $39 | 0.72% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET HONOLULU, HI 96813 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.30% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $16 | $16 | — |
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 | 356 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 359 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 442 | $5.9M |
| Dental | HAWAII DENTAL SERVICE | 856 | $802K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 442 | $5.2M |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 356 | $627K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 356 | $627K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 442 | $5.9M |
| Other(7 contracts, 5 carriers) | SYMETRA LIFE INSURANCE COMPANY | 356 | $722K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 856 | — |
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.