| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP PLAN ADMINISTRATORS3 Filed as: GROUP PLAN ADMINISTRATORS, INC. | 222 SOUTH VINEYARD STREET PH4 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $4K | — | $4K | 2.53% |
| GROUP PLAN ADMINISTRATORS3 | 222 S VINEYARD STREET, PH4 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE CO | $2K | — | $2K | 5.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP PLAN ADMINISTRATORS INC EIN 99-0187572 NONE | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Direct payment from the plan; Consulting fees Service code 14 | 222 SOUTH VINEYARD ST PH4 HONOLULU, HI 96813 | $76K |
| MC GROUP HAWAII INC EIN 27-3701730 NONE | Accounting (including auditing) Service code 10 | P.O. BOX 62030 HONOLULU, HI 96839 | $19K |
| YAMAMOTO CALIBOSO EIN 20-5115756 NONE | Legal Service code 29 | 1100 ALAKEA ST 3100 HONOLULU, HI 96813 | $11K |
| CENTRAL PACIFIC BANK EIN 99-0309010 NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | 220 S KING STREET HONOLULU, HI 96813 | $10K |
| BENEFIT & RISK MANAGEMENT SERVICES EIN 68-0306908 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Direct payment from the plan; Plan Administrator; Consulting fees Service code 14 | 560 N. NIMITZ HWY STE 209 HONOLULU, HI 96817 | $8K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Insurance services Service code 23 | 180 HOWARD ST. STE 1100 SAN FRANCISCO, CA 94105 | $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 | 188 | 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) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 454 | $2.5M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 190 | $420K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 454 | $2.5M |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE CO | 202 | $35K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 454 | $2.2M |
| Stop-loss / reinsurancereinsurance | HAWAII MEDICAL SERVICE ASSOCIATION | 454 | $2.2M |
| Other | PACIFIC GUARDIAN LIFE INSURANCE CO | 202 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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.