| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET, 14TH FLOOR HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $91 | — | $91 | 0.17% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET, SUITE 1400 HONOLULU, HI 968134116 | METROPOLITAN LIFE INSURANCE COMPANY | $184 | — | $184 | 1.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UBS FINANCIAL SERVICES, INC. EIN 13-2638166 NONE | Investment advisory (plan); Shareholder servicing fees; Direct payment from the plan Service code 27 | — | $40K |
| ACCUITY LLP EIN 20-5325889 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $32K |
| TOWERS WATSON EIN 53-0181291 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $9K |
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 | 240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 130 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICES ASSOCIATION | 103 | $336K |
| Vision | VISION SERVICE PLAN | 60 | $7K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 110 | $9K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICES ASSOCIATION | 103 | $336K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.