| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 Filed as: BENEFIT & RISK MANAGEMENT SVCS | 80 IRON POINT CIRCLE STE 200 FOLSOM, CA 95630 | PACIFIC GUARDIAN LIFE INSURANCE CO | $2K | — | $2K | 4.59% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: BENEFIT & RISK MANAGEMENT SERVICES | 80 IRON POINT CIRCLE STE200 FOLSOM, CA 95630 | HAWAII DENTAL SERVICE | $4K | — | $4K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| 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 Service code 14 | 560 N. NIMITZ HWY STE 209 HONOLULU, HI 96817 | $64K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Consulting (general); Insurance services Service code 16 | 180 HOWARD ST. STE 1100 SAN FRANCISCO, CA 94105 | $27K |
| MC GROUP HAWAII INC EIN 27-3701730 NONE | Accounting (including auditing) Service code 10 | P.O. BOX 62030 HONOLULU, HI 96839 | $14K |
| CENTRAL PACIFIC BANK EIN 99-0309010 NONE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | 220 S KING STREET HONOLULU, HI 96813 | $11K |
| YAMAMOTO CALIBOSO EIN 20-5115756 NONE | Legal Service code 29 | 1100 ALAKEA ST 3100 HONOLULU, HI 96813 | $5K |
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 | 402 | $2.4M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 415 | $288K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 402 | $2.4M |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE CO | 192 | $34K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 402 | $2.1M |
| Stop-loss / reinsurancereinsurance | HAWAII MEDICAL SERVICE ASSOCIATION | 402 | $2.1M |
| Other | PACIFIC GUARDIAN LIFE INSURANCE CO | 192 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 415 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.