No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE EIN 36-2735957 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1.5M |
| AETNA EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $206K |
| METLIFE EIN 13-5581829 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $54K |
| FRAZIER & DEETER, LLC EIN 58-1433845 AUDITOR | Accounting (including auditing) Service code 10 | — | $26K |
| JP MORGAN CHASE EIN 13-4994650 PARTY-IN-INTEREST | Investment advisory (plan); Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $8K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10,339 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 10,339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF HAWAII | 19 | $157K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF HAWAII | 19 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 19 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.