| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 333 WEST 34TH ST NEW YORK, NY 10001 | UNION LABOR LIFE INSURANCE COMPANY | $703 | — | $703 | 4.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HAWAII MEDICAL SERVICE ASSOCIATION EIN 99-0040115 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $2.3M |
| ZENITH AMERICAN SOLUTIONS INC. NONE | Direct payment from the plan; Plan Administrator Service code 14 | 1141 HARBOR BAY PKWY STE 100 ALAMEDA, CA 94502 | $275K |
| MULTI-PLAN SERVICES AGENCY INC. EIN 81-3751949 NONE | Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan Service code 10 | — | $156K |
| SSI INVESTMENT MANAGEMENT EIN 95-2913505 NONE | Soft dollars commissions; Investment management fees paid directly by plan; Investment management Service code 28 | — | $113K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $75K |
| SALTZMAN & JOHNSON EIN 94-2376174 NONE | Legal; Direct payment from the plan Service code 29 | — | $56K |
| OAKHURST CAPITAL MGMT NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 1875 CENTURY PARK E STE 950 LOS ANGELES, CA 90067 | $47K |
| PHARMACY BENEFIT SOLUTIONS INC NONE | Consulting (general); Direct payment from the plan Service code 16 | 8421 AUBURN BLVD STE 280 CITRUS HEIGHTS, CA 95610 | $44K |
| MCMORGAN & COMPANY EIN 94-1650768 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $36K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $31K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $29K |
| RAYMOND JAMES NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | PO BOX 23641 ST PETERSBURG, FL 33742 | $20K |
| ASSISTANCE RECOVERY PROGRAM EIN 94-3042622 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $15K |
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 | 2,073 | 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) | 2,073 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 932 | $4.9M |
| Dental | HAWAII DENTAL SERVICE | 5,454 | $2.4M |
| Vision | VISION SERVICE PLAN | 1,832 | $173K |
| Life insurance(2 contracts, 2 carriers) | PACIFIC GUARDIAN LIFE INS CO LTD | 1,830 | $753K |
| Long-term disability | PACIFIC GUARDIAN LIFE INS CO LTD | 1,830 | $737K |
| Stop-loss / reinsurancereinsurance | HAWAII MEDICAL SERVICE ASSOCIATION | 4,461 | $1.6M |
| Other | HAWAII MEDICAL SERVICE ASSOCIATION | 4,461 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,454 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.