| 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 | $567 | — | $567 | 4.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HAWAII MEDICAL SERVICE ASSOCIATION EIN 99-0040115 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $924K |
| ZENITH AMERICAN SOLUTIONS INC. NONE | Plan Administrator; Direct payment from the plan Service code 14 | 1141 HARBOR BAY PKWY STE 100 ALAMEDA, CA 94502 | $241K |
| MULTI-PLAN SERVICES AGENCY INC. EIN 81-3751949 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $114K |
| SSI INVESTMENT MANAGEMENT EIN 95-2913505 NONE | Investment management fees paid directly by plan; Investment management; Soft dollars commissions Service code 28 | — | $100K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $92K |
| SALTZMAN & JOHNSON EIN 94-2376174 NONE | Legal; Direct payment from the plan Service code 29 | — | $57K |
| MCMORGAN & COMPANY EIN 94-1650768 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $45K |
| 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 | $44K |
| PHARMACY BENEFIT SOLUTIONS INC NONE | Direct payment from the plan; Consulting (general) Service code 16 | 8421 AUBURN BLVD STE 280 CITRUS HEIGHTS, CA 95610 | $40K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $29K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $27K |
| 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 | — | $13K |
| MAILRITE PRINT & MAIL INC NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 834 STRIKE AVE STE C SACRAMENTO, CA 95834 | $5K |
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 | 1,815 | 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) | 1,815 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HAWAII DENTAL SERVICE | 5,022 | $2.2M |
| Vision | VISION SERVICE PLAN | 1,678 | $169K |
| Life insurance(2 contracts, 2 carriers) | PACIFIC GUARDIAN LIFE INS CO LTD | 1,675 | $661K |
| Long-term disability | PACIFIC GUARDIAN LIFE INS CO LTD | 1,675 | $649K |
| Stop-loss / reinsurancereinsurance | HAWAII MEDICAL SERVICE ASSOCIATION | 4,191 | $1.5M |
| Other | HAWAII MEDICAL SERVICE ASSOCIATION | 4,191 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,022 | — |
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.