| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PSH INSURANCE, INC.3 Filed as: PSH INSURANCE INC | 737 BISHOP ST STE 2120 HONOLULU, HI 96813 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $25K | — | $25K | 3.00% |
| P.S.H. INSURANCE, INC.3 | 737 BISHOP ST., #2120 HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $8K | — | $8K | 3.57% |
| PSH INSURANCE, INC.3 Filed as: PSH INSURANCE INC | 737 BISHOP STREET STE 2120 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $2K | — | $2K | 2.94% |
| PSH INSURANCE, INC.3 Filed as: PSH INSURANCE INC. | 737 BISHOP ST STE 2120 HONOLULU, HI 96813 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $265 | — | $265 | 9.98% |
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 | 139 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 133 | $1.1M |
| Dental | HAWAII DENTAL SERVICE | 156 | $53K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 133 | $1.1M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 125 | $3K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 133 | $1.1M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 125 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.