| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | HAWAII MEDICAL SERVICE ASSOCIATION | — | — | $0 | 0.00% |
| GROUP PLAN ADMINISTRATORS3 | 222 S VINEYARD ST PH-4 HONOLULU, HI 98613 | HAWAII DENTAL SERVICE | $5K | — | $5K | 2.55% |
| GROUP PLAN ADMINISTRATORS3 | 222 S VINEYARD ST PH-4 HONOLULU, HI 98613 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $2K | — | $2K | 4.41% |
| NONE | — | KAISER FOUNDATION HEALTH PLAN OF HAWAII | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP PLAN ADMINISTRATORS, INC. EIN 99-0187572 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Plan Administrator Service code 14 | — | $78K |
| CENTRAL PACIFIC BANK EIN 99-0309010 NONE | Investment management fees paid indirectly by plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $9K |
| THE SEGAL COMPANY EIN 94-1503999 N | Direct payment from the plan; Actuarial Service code 11 | — | $9K |
| G. USHIJIMA CPA LLC EIN 20-1318913 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $6K |
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 568 | $2.0M |
| Dental | HAWAII DENTAL SERVICE | 510 | $187K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 568 | $2.0M |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 180 | $38K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 568 | $2.0M |
| Stop-loss / reinsurancereinsurance | HAWAII MEDICAL SERVICE ASSOCIATION | 568 | $2.0M |
| Other | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 180 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 568 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.