| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RICHARD I KERSTEN3 Filed as: RICHARD IRA KERSTEN | 458 AULIMA LOOP KAILUA, HI 96734 | HARTFORD LIFE INSURANCE CO. | $78K | — | $78K | 6.82% |
| MARY M MATTOS3 | 355-A HUALANI STREET KAILUA, HI 96734 | HARTFORD LIFE INSURANCE CO. | $59K | — | $59K | 5.16% |
| RICHARD I KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | HAWAII DENTAL SERVICE | $7K | — | $7K | 0.89% |
| RICHARD I KERSTEN3 Filed as: RICHARD IRA KERSTEN | 458 AULIMA LOOP KAILUA, HI 96734 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $45K | — | $45K | 7.58% |
| MARY M MATTOS3 | 355-A HUALANI STREET KAILUA, HI 96734 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $45K | — | $45K | 7.58% |
| RICHARD I KERSTEN3 Filed as: RICHARD IRA KERSTEN | 458 AULIMA LOOP KAILUA, HI 96734 | HARTFORD LIFE INSURANCE COMPANY | $31K | — | $31K | 10.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 181 EAST 5600 SOUTH, STE 240 SALT LAKE CITY, UT 84107 | HARTFORD LIFE INSURANCE COMPANY | $3K | $11K | $14K | 4.67% |
| MARY M MATTOS3 Filed as: MARY MATTOS | 355A HUALANI STREET KAILUA, HI 96734 | HARTFORD LIFE INSURANCE COMPANY | $11K | — | $11K | 3.75% |
| RICHARD I KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | ZURICH AMERICAN INSURANCE COMPANY | $2K | — | $2K | 7.50% |
| MARY M MATTOS3 | 355-A HUALANI STREET KAILUA, HI 96734 | ZURICH AMERICAN INSURANCE COMPANY | $2K | — | $2K | 7.50% |
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 | 572 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 169 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 741 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HAWAII DENTAL SERVICE | 2,019 | $816K |
| Life insurance | HARTFORD LIFE INSURANCE COMPANY | 697 | $304K |
| Long-term disability | HARTFORD LIFE INSURANCE CO. | 472 | $1.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 535 | $615K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,019 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.