| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET SUITE 1400 HONOLULU, HI 96813 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $9K | — | $9K | 3.25% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET SUITE 1400 HONOLULU, HI 96813 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $6K | — | $6K | 3.24% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET SUITE 1400 HONOLULU, HI 96813 | GROUP HEALTH COOPERATIVE | $3K | — | $3K | 3.56% |
| SIS WASHINGTON LLC3 | 1100 DEXTER AVE N SUITE 220 SEATTLE, WA 98109 | GROUP HEALTH COOPERATIVE | $2K | — | $2K | 1.80% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET SUITE 1400 HONOLULU, HI 96813 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 11.25% |
| FIRST HAWAIIAN INSURANCE INC3 | P.O. BOX 3200 HONOLULU, HI 96847 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.00% |
| BOBBIE E MA3 Filed as: BOBBIE E. MA | 5551 LEMONMINT LN PRESCOTT, AZ 86305 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $459 | — | $459 | 0.75% |
| BENEFIT PLAN SOLUTIONS, INC.3 | 680 IWILEI ROAD SUITE 528 HONOLULU, HI 96817 | HAWAII DENTAL SERVICE | $252 | — | $252 | 2.00% |
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 | 1,149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,009 | $10.1M |
| Dental(4 contracts) | HAWAII DENTAL SERVICE | 1,759 | $841K |
| Vision(7 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,009 | $10.1M |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 832 | $264K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 778 | $187K |
| Prescription drug(7 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,009 | $10.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,149 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,759 | — |
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.
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.