Filings through .
History & trajectory Charts need 2 or more years. This plan has 10 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingNo prospect flags tripped on this filing.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 8 contracts with Pro. Pro is free for 7 days and then costs $49 a month.
These benefits are declared on the Form 5500 main form. A ✓ means the benefit also has a Schedule A insurance contract. Without one, plan assets or a Schedule C TPA fund the benefit.
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 9,086 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 46 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 9,132 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 22 | $148K |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 22 | $148K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 17,319 | $995K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 15,536 | $6.7M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 12,121 | $5.2M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 12,121 | $5.2M |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 7,191 | $1.2M |
| Other(2 contracts, 2 carriers) | METLIFE LEGAL PLANS | 3,002 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 17,319 | - |
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 instead of this filer's headcount. We show the row, but it does not count the people in this plan.
Brokers paid through Schedule A and service providers paid through Schedule C.
| Broker | Commissions |
|---|---|
Carrier: Metropolitan Life Insurance Company | |
Carrier: Reliastar Life Insurance Company | |
Carrier: Reliastar Life Insurance Company | |
Carrier: Hartford Life and Accident |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLEGIANCE BENEFIT PLAN MANAGEMENT EIN 81-0400550 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $2.7M |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $2.2M |
| RELIASTAR LIFE INSURANCE COMPANY EIN 41-0451140 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $1.3M |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 INSURANCE AGENT/BROKER | Contract Administrator; Claims processing Service code 12 | — | $529K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $386K |
| AETNA BEHAVIORAL HEALTH, LCC EIN 33-0052273 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $300K |
| SB & COMPANY, LLC EIN 20-2153727 ACCOUNTING SERVICES | Accounting (including auditing) Service code 10 | — | $30K |
This section shows how the plan is funded and what that means for risk.
Welfare charges, retention and retention rate (the carrier margin on this plan) are on Pro.
4 contacts
Phone and email for the top hat administrator are on Pro.
10 filings · 2016 to 2025