| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PSH INSURANCE, INC.3 | 737 BISHOP STREET, SUITE 2120 HONOLULU, HI 96813 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $22K | $0 | $22K | 2.74% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $2K | $0 | $2K | 0.21% |
| PSH INSURANCE, INC.3 | 737 BISHOP STREET, SUITE 2120 HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | $0 | $7K | 3.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN, INC. | $608 | $0 | $608 | 0.28% |
| PSH INSURANCE, INC.3 | 737 BISHOP STREET, SUITE 2120 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $2K | $0 | $2K | 2.99% |
| PSH INSURANCE, INC.3 | 737 BISHOP STREET, SUITE 2120 HONOLULU, HI 96813 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $322 | $24 | $346 | 8.95% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $65 | $32 | $97 | 2.51% |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 134 | $1.0M |
| Dental | HAWAII DENTAL SERVICE | 181 | $59K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 134 | $1.0M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $4K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 134 | $1.0M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.