| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $30K | — | $30K | 3.48% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | HMAA | $21K | — | $21K | 2.56% |
| GAVIN TOMA3 | 220 SOUTH KING STREET SUITE 1200 HONOLULU, HI 96813 | HMAA | $10K | — | $10K | 1.27% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | USABLE LIFE | $17K | $3K | $19K | 14.87% |
| PATTERSON JR, DOUGLAS3 | PO BOX 860 HONOLULU, HI 96808 | USABLE LIFE | $2K | — | $2K | 1.37% |
| VARIOUS - SEE ATTACHMENT3 | PO BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 20.58% |
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 | 461 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 463 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 359 | $1.7M |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 359 | $1.7M |
| Life insurance | USABLE LIFE | 432 | $131K |
| Long-term disability | USABLE LIFE | 432 | $131K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 359 | $1.7M |
| Other(4 contracts, 4 carriers) | HMAA | 461 | $980K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 461 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.