| 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 | — | HAWAII MEDICAL SERVICE ASSOCIATION | — | — | $0 | 0.00% |
| NONE | — | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD | — | — | $0 | 0.00% |
| NONE | — | HAWAII MEDICAL SERVICE ASSOCIATION | — | — | $0 | 0.00% |
| THE SEGAL COMPANY3 | 333 WEST 34TH STREET NEW YORK, NY 10001 | THE UNION LABOR LIFE INSURANCE COMPANY | $557 | — | $557 | 4.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HMSA ADMIN EIN 99-0040115 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $807K |
| ZENITH AMERICAN SOLUTIONS NONE | Direct payment from the plan; Plan Administrator Service code 14 | 1600 HARBOR BAY PARKWAY, SUITE 200 ALAMEDA, CA 94502 | $223K |
| SSI INVESTMENT MANAGEMENT EIN 95-2913505 NONE | Investment management; Soft dollars commissions; Investment management fees paid directly by plan Service code 28 | — | $95K |
| SEGAL COMPANY EIN 94-1503999 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $70K |
| PHARMACY BENEFIT SOLUTIONS INC NONE | Direct payment from the plan; Consulting (general) Service code 16 | 8421 AUBURN BLVD. SUITE 280 CITRUS HEIGHS, CA 95610 | $70K |
| SALTZMAN & JOHNSON EIN 94-2376174 NONE | Legal; Direct payment from the plan Service code 29 | — | $55K |
| MCMORGAN & COMPANY EIN 94-1650768 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $46K |
| OAKHURST CAPITAL MANAGEMENT NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 1875 CENTURY PARK EAST SUITE 950 LOS ANGELES, CA 90067 | $45K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $29K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $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 |
| VISION SERVICE PLAN EIN 99-0247673 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $20K |
| KATHLEEN THURSTON EIN 94-6182984 NONE | Trustee (individual) Service code 20 | — | $7K |
| ASSISTANCE RECOVERY PROGRAM EIN 94-3042622 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $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 | 1,587 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,587 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HAWAII DENTAL SERVICE | 4,851 | $2.2M |
| Life insurance(2 contracts, 2 carriers) | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD | 1,601 | $584K |
| Short-term disability | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD | 1,601 | $572K |
| Other(2 contracts) | HAWAII MEDICAL SERVICE ASSOCIATION | 4,153 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,851 | — |
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.