| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $229 | — | $229 | 0.40% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP ST, 14TH FLOOR HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $28 | — | $28 | 0.05% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP ST. SUITE 1400 HONOLULU, HI 96813 | METROPOLITAN LIFE INSURANCE COMPANY | $40 | — | $40 | 0.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVE. NE, SUITE 200 BELLEVUE, WA 98004 | METROPOLITAN LIFE INSURANCE COMPANY | $39 | — | $39 | 0.38% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO EMPLOYEE BENEFITS CONSULTING | 700 BISHOP ST, STE 1400 HONOLULU, HI 968134116 | VISION SERVICE PLAN | $67 | — | $67 | 1.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER REPPOND A DIVISION | OF GALLAGHER BENEFIT SERVICES 777 108TH AVE. NE, SUITE 200 BELLEVUE, WA 980045120 | VISION SERVICE PLAN | $8 | — | $8 | 0.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACCUITY LLP EIN 20-5325889 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $34K |
| TOWERS WATSON DELAWARE INC. EIN 53-0181291 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $22K |
| UBS FINANCIAL SERVICES, INC. EIN 13-2638166 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $21K |
| SCHWAB RETIREMENT PLAN SERVICES INC EIN 34-1479833 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Shareholder servicing fees Service code 15 | — | $2K |
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 | 241 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 140 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 381 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICES ASSOCIATION | 95 | $399K |
| Vision | VISION SERVICE PLAN | 52 | $6K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 111 | $10K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICES ASSOCIATION | 95 | $399K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.