| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN HONOLULU, HI 96813 | HAWAII MEDICAL SERVICE ASSOCIATION | $19K | $0 | $19K | 1.68% |
| ASSUREDPARTNERS3 | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | $0 | $12K | 3.50% |
| ASSUREDPARTNERS3 | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $4K | $20K | 7.98% |
| ASSUREDPARTNERS3 | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $4K | $1 | $4K | 4.00% |
| ASSUREDPARTNERS3 | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 12.25% |
| KRISTA K PRICE3 Filed as: KRISTA KAYLENE PRICE | 3864 SOUTH QUINCE STREET DENVER, CO 80237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $443 | $0 | $443 | 2.13% |
| JASON C CRANE3 Filed as: JASON C. CRANE | 92-1219 HOOKEHA STREET KAPOLEI, HI 96707 | CONTINENTAL AMERICAN INSURANCE COMPANY | $391 | $0 | $391 | 1.88% |
| JUDITH H. MAGIN3 | 1155 WILDER AVENUE, APARTMENT 208 HONOLULU, HI 96822 | CONTINENTAL AMERICAN INSURANCE COMPANY | $272 | $0 | $272 | 1.31% |
| TYLER K PANG3 Filed as: TYLER K. PANG | 2510 RAINBOW DRIVE HONOLULU, HI 96822 | CONTINENTAL AMERICAN INSURANCE COMPANY | $220 | $0 | $220 | 1.06% |
| BARRY M SCOFF3 Filed as: BARRY M. SCOFF | 82 SANDS HILLS ROAD KENDALL PARK, NJ 08824 | CONTINENTAL AMERICAN INSURANCE COMPANY | $187 | $0 | $187 | 0.90% |
| MJ INSURANCE3 Filed as: MARCUS GRIEGO AND VARIOUS AGENTS | PO BOX 8937 HONOLULU, HI 96830 | CONTINENTAL AMERICAN INSURANCE COMPANY | $95 | $0 | $95 | 0.46% |
| ASSUREDPARTNERS3 | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 20.79% |
| ASSUREDPARTNERS3 | 941 OAK STREET EUGENE, OR 97401 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $253 | $0 | $253 | 2.53% |
No Schedule C service providers reported on this filing.
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 | 170 | 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) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 160 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 388 | $252K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 388 | $252K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 388 | $252K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 388 | $252K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 388 | $252K |
| Prescription drug(6 contracts, 6 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 160 | $1.6M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 388 | $287K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 388 | — |
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."
No prospect flags tripped on this filing.