| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GAVIN TOMA3 | 737 BISHOP STREET, STE 1200 HONOLULU, HI 96813 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $23K | — | $23K | 1.93% |
| MERCER HEALTH AND BENEFITS, LLC3 | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $23K | — | $23K | 1.93% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $14K | — | $14K | 3.47% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | P.O. BOX 730212 DALLAS, TX 753730212 | HAWAII MEDICAL SERVICE ASSOCIATION | $4K | — | $4K | 3.02% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $12K | $261 | $12K | 15.16% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 12.50% |
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 | 282 | 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) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 310 | $1.7M |
| Dental(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 430 | $226K |
| Vision(3 contracts, 3 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 310 | $1.7M |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 287 | $151K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 287 | $73K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 310 | $1.6M |
| Other(4 contracts, 4 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 310 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 430 | — |
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."
No prospect flags tripped on this filing.