| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GAVIN TOMA3 | 737 BISHOP STREET SUITE 1200 HONOLULU, HI 96813 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $18K | — | $18K | 1.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $18K | — | $18K | 1.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $14K | $608 | $15K | 3.66% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | P.O. BOX 730212 DALLAS, TX 753730212 | HMSA | $4K | — | $4K | 2.63% |
| RICHARD KERSTEN3 Filed as: RICHARD FONSECA JR. | 737 BISHOP STREET SUITE 2120 HONOLULU, HI 96813 | AFLAC | $3K | $269 | $3K | 4.36% |
| MICHAEL I ING3 Filed as: MICHAEL I. ING | 363 KIKOO PLACE HONOLULU, HI 96825 | AFLAC | $1K | $159 | $2K | 2.27% |
| MAYUMI FULKERSON3 | 1031 NUUANU AVENUE APT. 1201 HONOLULU, HI 96817 | AFLAC | $666 | $109 | $775 | 1.06% |
| PIONEER PACIFIC FINANCIAL3 | 1132 BISHOP STREET SUITE 2101 HONOLULU, HI 96813 | AFLAC | $718 | — | $718 | 0.98% |
| DUSTIN DEAN DENIZ3 | 222 LILIUOKALANI AVENUE APT. 803 HONOLULU, HI 96815 | AFLAC | $546 | $123 | $669 | 0.92% |
| HAWAII PASIFIKA LLC3 | 1100 ALAKEA STREET SUITE 3200 HONOLULU, HI 96813 | AFLAC | $497 | $123 | $620 | 0.85% |
| CHARLES A. KAAHANUI3 | 1742 YOUNG STREET APT. 104 HONOLULU, HI 96826 | AFLAC | $456 | — | $456 | 0.62% |
| KENNETH T. TOMITA3 | 3138 WAIALAE AVENUE APT. 532 HONOLULU, HI 96816 | AFLAC | $438 | — | $438 | 0.60% |
| GALEN MIZUGUCHI3 | 17 MAKAALA STREET #101 HILO, HI 96720 | AFLAC | $358 | — | $358 | 0.49% |
| PSH INSURANCE, INC.3 Filed as: PSH INSURANCE INC. | 737 BISHOP STREET SUITE 2120 HONOLULU, HI 96813 | AFLAC | $319 | — | $319 | 0.44% |
| CHRISTIAN FERMAHIN3 | 98-360 KOAUKA LOOP SUITE 206 AIEA, HI 96701 | AFLAC | $317 | — | $317 | 0.43% |
| GLEN M MIYAMOTO3 Filed as: GLEN M. MIYAMOTO | P.O. BOX 62971 EWA BEACH, HI 96706 | AFLAC | $291 | — | $291 | 0.40% |
| KYLE C KWOCK3 Filed as: KYLE C. KWOCK | 1667 KAUMOLI STREET PEARL CITY, HI 96782 | AFLAC | $263 | — | $263 | 0.36% |
| CALVIN L MALINA JR3 Filed as: CALVIN L. MALINA JR. | 1888 KALAKAUA AVENUE SUITE C312-334 HONOLULU, HI 96815 | AFLAC | $257 | — | $257 | 0.35% |
| RAYANNE K.K. MCCOLLOUGH3 | 2177 AINAKAHELE STREET HILO, HI 96720 | AFLAC | $172 | $57 | $229 | 0.31% |
| RUSSELL A. HAYASHI3 | P.O. BOX 20 PEPEEKEO, HI 96783 | AFLAC | $202 | — | $202 | 0.28% |
| PATTIE L ARANIO3 Filed as: PATTIE L. ARANIO | 1136 UNION MALL SUITE 705 HONOLULU, HI 96813 | AFLAC | $184 | — | $184 | 0.25% |
| JULIE C GUSHIKEN3 Filed as: JULIE C. GUSHIKEN | 1138 MANONO STREET HILO, HI 96720 | AFLAC | $171 | — | $171 | 0.23% |
| COLIN D FUKAMI3 Filed as: COLIN D. FUKAMI | 98-1277 KAAHUMANU STREET 106-364 AIEA, HI 96701 | AFLAC | $118 | — | $118 | 0.16% |
| MARLA S TAKAMORI3 Filed as: MARLA S. TAKAMORI | 765 AMANA STREET SUITE 202 HONOLULU, HI 96814 | AFLAC | $115 | — | $115 | 0.16% |
| KAI M TAKEKAWA3 Filed as: KAI M. TAKEKAWA | 1378 HONOKAHUA STREET HONOLULU, HI 96825 | AFLAC | $114 | — | $114 | 0.16% |
| DERRICK A FUJIOKA3 Filed as: DERRICK A. FUJIOKA | 91-1100 PUAHALA STREET APT. S EWA BEACH, HI 96706 | AFLAC | $62 | — | $62 | 0.08% |
| MEL W S CHOW AND ASSOC INC3 Filed as: MEL W.S. CHOW AND ASSOCIATES INC. | 1268 YOUNG STREET SUITE 201 HONOLULU, HI 96814 | AFLAC | $56 | — | $56 | 0.08% |
| BRONSON K SISMAR3 Filed as: BRONSON K. SISMAR | 740A HUKINI STREET HONOLULU, HI 96825 | AFLAC | $54 | — | $54 | 0.07% |
| CELINA UEHARA3 | 91-6555 KAPOLEI PARKWAY EWA BEACH, HI 96706 | AFLAC | $49 | — | $49 | 0.07% |
| ANGELITA M. PASION3 | 98-563 KAIMU LP AIEA, HI 96701 | AFLAC | $48 | — | $48 | 0.07% |
| LEATRICE A GRANTHAM3 Filed as: LEATRICE A. GRANTHAM | 94820 LUMIAUAU STREET C 204 WAIPAHU, HI 96797 | AFLAC | $39 | — | $39 | 0.05% |
| JOHN J. DELEE3 | 44-140 MUI PLACE APT. 8 KANEOHE, HI 96744 | AFLAC | $35 | — | $35 | 0.05% |
| MARJORIE C ROBINSON3 Filed as: MARJORIE C. ROBINSON | 91-1095 KAIKO STREET EWA BEACH, HI 96706 | AFLAC | $35 | — | $35 | 0.05% |
| LYNN S GUSHIKEN3 Filed as: LYNN D. GUSHIKEN | 432 MAUNA IHO PLACE HILO, HI 96720 | AFLAC | $32 | — | $32 | 0.04% |
| PAMELA A. DAYTON3 | 1913 HOUGHTAILING STREET HONOLULU, HI 96817 | AFLAC | $31 | — | $31 | 0.04% |
| FREDERICK H. LEE3 | 1389 KAELEKU STREET HONOLULU, HI 96825 | AFLAC | $30 | — | $30 | 0.04% |
| STEVEN KAISER3 | 519 NE 6TH AVENUE DEERFIELD BEACH, FL 33441 | AFLAC | $28 | — | $28 | 0.04% |
| JARED M. MIYAMOTO3 | P.O. BOX 62971 EWA BEACH, HI 96706 | AFLAC | $25 | — | $25 | 0.03% |
| PIOPAC FIDELITY3 | 1132 BISHOP STREET #2101 HONOLULU, HI 96813 | AFLAC | $25 | — | $25 | 0.03% |
| ENROLLEASE3 Filed as: CLARKE T. TERUYA | 1253 SOUTH BERETANIA STREET SUITE 2904 HONOLULU, HI 96814 | AFLAC | $22 | — | $22 | 0.03% |
| STEPHEN H ARANIO3 Filed as: STEPHEN H. ARANIO | 1136 UNION MALL SUITE 705 HONOLULU, HI 96813 | AFLAC | $18 | — | $18 | 0.02% |
| MALCOLM MATSUOKA3 | 1199 BISHOP STREET APT. 1401 HONOLULU, HI 96813 | AFLAC | $16 | — | $16 | 0.02% |
| CELINA UEHARA3 | 91-1031 KAIMALIE STREET APT. 4M2 EWA BEACH, HI 96706 | AFLAC | $15 | — | $15 | 0.02% |
| DAVID S. MCDONNELL3 | 7004 W. PIERCE COURT YAKIMA, WA 98908 | AFLAC | $14 | — | $14 | 0.02% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $7K | — | $7K | 10.81% |
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 | 312 | 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) | 312 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 295 | $1.3M |
| Dental(2 contracts, 2 carriers) | HMSA | 419 | $207K |
| Vision(3 contracts, 3 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 295 | $1.4M |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 282 | $62K |
| Long-term disability | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 282 | $62K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 295 | $1.3M |
| Other(3 contracts, 3 carriers) | AFLAC | 303 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 419 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.