| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | HAWAII MEDICAL SERVICE ASSOCIATION | — | — | $0 | 0.00% |
| NONE | — | KAISER FOUNDATION HEALTH PLAN OF HAWAII | — | — | $0 | 0.00% |
| NONE | — | HAWAII DENTAL SERVICE | — | — | $0 | 0.00% |
| GROUP PLAN ADMINISTRATORS3 | 222 S VINEYARD STREET PH-4 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $2K | — | $2K | 4.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP PLAN ADMINISTRATORS, INC. EIN 99-0187572 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 14 | — | $82K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $18K |
| CHAR SAKAMOTO ISHII LUM & CHING ATT EIN 99-0268206 NONE | Legal; Direct payment from the plan Service code 29 | — | $12K |
| CENTRAL PACIFIC BANK EIN 99-0309010 NONE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $10K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $8K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan 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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 511 | $2.2M |
| Dental | HAWAII DENTAL SERVICE | 476 | $167K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 511 | $2.2M |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 200 | $34K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 511 | $2.2M |
| Stop-loss / reinsurancereinsurance | HAWAII MEDICAL SERVICE ASSOCIATION | 511 | $2.2M |
| Other | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 200 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 511 | — |
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.