| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY | 1132 BISHOP STREET, SUITE 1600 HONOLULU, HI 96813 | UNIVERSITY HEALTH ALLIANCE | $5K | — | $5K | 4.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $1.6M |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CLAIMS PROCESSOR | Contract Administrator; Claims processing Service code 12 | — | $126K |
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 | 6,041 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 6,041 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 26 | $316K |
| Dental | UNIVERSITY HEALTH ALLIANCE | 15 | $98K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 2,253 | $457K |
| Prescription drug | UNIVERSITY HEALTH ALLIANCE | 15 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,253 | — |
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.