| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $17K | — | $17K | 3.75% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 FIFTH AVENUE, SUITE 1500 SEATTLE, WA 98101 | HAWAII DENTAL SERVICE | $3K | — | $3K | 1.99% |
| EMPLOYEE BENEFITS RESOURCE, INC.3 Filed as: EMPLOYEE BENEFITS RESOURCE INC. | 700 BISHOP STREET SUITE 502 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $2K | — | $2K | 9.27% |
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 | 795 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 799 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 587 | $1.6M |
| Dental(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 634 | $666K |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 587 | $1.6M |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 534 | $21K |
| Prescription drug(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 587 | $1.6M |
| Other | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 534 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 634 | — |
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.