| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GAVIN TOMA3 | 737 BISHOP STREET SUITE 1200 HONOLULU, HI 96813 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $24K | — | $24K | 1.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $24K | — | $24K | 1.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $16K | — | $16K | 3.44% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER | P.O. BOX 730212 DALLAS, TX 753730212 | HAWAII MEDICAL SERVICE ASSOCIATION | $3K | — | $3K | 1.66% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $942 | $8K | 10.30% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $11K | $199 | $11K | 14.79% |
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 | 372 | 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) | 372 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 325 | $2.1M |
| Dental(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 462 | $231K |
| Vision(3 contracts, 3 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 325 | $2.1M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 313 | $155K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 313 | $82K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 325 | $2.0M |
| Other(4 contracts, 4 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 500 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 500 | — |
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.