| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| A M SEGAWA INSURANCE SERVICES, INC.3 | 47-392A AHUIMANU PLACE KANEOHE, HI 96744 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 3.48% |
| AMERICAN MUTUAL GROUP3 | 1357 KAPIOLANI BLVD., SUITE 1000 HONOLULU, HI 96814 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $905 | $0 | $905 | 1.49% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE, SUITE 1100 CHICAGO, ID 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $84 | $84 | 0.14% |
| A M SEGAWA INSURANCE SERVICES, INC.3 | 47-392A AHUIMANU PLACE KANEOHE, HI 96744 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 4.81% |
| AMERICAN MUTUAL GROUP3 | 1357 KAPIOLANI BLVD., SUITE 1000 HONOLULU, HI 96814 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $550 | $0 | $550 | 2.06% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE., SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $37 | $37 | 0.14% |
| ALAN M. SEGAWA3 | C/O ATLAS INSURANCE AGENCY 820 MILILANI STREET, 3RD FLOOR HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $2K | $0 | $2K | 9.03% |
| INSURANCE PLANNING GROUP3 Filed as: INSURANCE PLANNING CORP | 6844 E THUNDERBIRD RD SCOTTSDALE, AZ 852544045 | AMERICAN HERITAGE LIFE INSURANCE | $62 | $0 | $62 | 5.02% |
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 | 255 | 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) | 255 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 471 | $2.0M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 471 | $1.6M |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 471 | $2.0M |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 251 | $87K |
| Long-term disability | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 246 | $26K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 471 | $2.0M |
| Other(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 251 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 471 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.