| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER FOUNDATION HEALTH PLAN OF HAWAII | — | — | $0 | 0.00% |
| NONE | — | HAWAII DENTAL SERVICE | — | — | $0 | 0.00% |
| NONE | — | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD | — | — | $0 | 0.00% |
| NONE | — | HAWAII MEDICAL SERVICE ASSOCIATION | — | — | $0 | 0.00% |
| NONE | — | VISION SERVICE PROVIDER | — | — | $0 | 0.00% |
| THE SEGAL COMPANY3 | 333 WEST 34TH STREET NEW YORK, NY 10001 | THE UNION LABOR LIFE INSURANCE COMPANY | $594 | — | $594 | 4.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HMSA ADMIN EIN 99-0040115 NONE | Claims processing; Direct payment from the plan Service code 12 | P.O. BOX 4720 HONOLULU, HI 968124720 | $670K |
| ZENITH AMERICAN SOLUTIONS NONE | Contract Administrator; Direct payment from the plan Service code 13 | 1600 HARBOR BAY PARKWAY, SUITE 200 ALAMEDA, CA 94502 | $234K |
| SEGAL COMPANY EIN 94-1503999 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $98K |
| SALTZMAN & JOHNSON EIN 94-2376174 NONE | Legal; Direct payment from the plan Service code 29 | — | $60K |
| MCMORGAN & COMPANY EIN 94-1650768 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $56K |
| SSI INVESTMENT MANAGEMENT EIN 95-2913505 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $50K |
| FIRST WESTERN TRUST BANK NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 1900 16TH STREET, SUITE 1200 DENVER, CO 80202 | $30K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $28K |
| VISION SERVICE PLAN EIN 99-0247673 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $21K |
| RAYMOND JAMES NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | PO BOX 23641 ST. PETERSBURG, FL 33742 | $20K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $18K |
| RANDALL CHING EIN 94-6182984 TRUSTEE | Direct payment from the plan; Trustee (directed) Service code 25 | — | $11K |
| KATHLEEN THURSTON EIN 94-6182984 TRUSTEE | Direct payment from the plan; Trustee (directed) Service code 25 | — | $8K |
| VAVRINEK, TRINE, DAY & CO., LLP EIN 95-2648289 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $8K |
| DANA INVESTMENT PARTNERS EIN 39-1512278 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $8K |
| ASSISTANCE RECOVERY PROGRAM EIN 94-3042622 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $6K |
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 | 1,635 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,635 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HAWAII DENTAL SERVICE | 5,191 | $2.5M |
| Vision | VISION SERVICE PROVIDER | 1,633 | $103K |
| Life insurance(2 contracts, 2 carriers) | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD | 1,630 | $530K |
| Short-term disability | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD | 1,630 | $517K |
| Other | HAWAII MEDICAL SERVICE ASSOCIATION | 4,468 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,191 | — |
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.