| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP ST., SUITE 1400 HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $20K | $0 | $20K | 1.00% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP ST., SUITE 1400 HONOLULU, HI 96813 | HAWAII MEDICAL SERVICE ASSOCIATION | $0 | $0 | $0 | 0.00% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP ST., SUITE 1400 HONOLULU, HI 96813 | HAWAII MEDICAL SERVICE ASSOCIATION | $0 | $0 | $0 | 0.00% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP ST., SUITE 1400 HONOLULU, HI 96813 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 8.00% |
| PIOPAC FIDELITY3 | 1132 BISHOP STREET #2101 HONOLULU, HI 96813 | AFLAC | $2K | $0 | $2K | 2.74% |
| DONNE M SOGA3 | 951008 HOAKULA STREET MILILANI, HI 96789 | AFLAC | $1K | $265 | $1K | 2.25% |
| PIONEER PACIFIC FINANCIAL3 | 1132 BISHOP ST., SUITE 2101 HONOLULU, HI 96813 | AFLAC | $988 | $76 | $1K | 1.86% |
| PSH INSURANCE, INC.3 Filed as: PSH INSURANCE INC. | 737 BISHOP STREET, SUITE 2120 HONOLULU, HI 96813 | AFLAC | $809 | $0 | $809 | 1.42% |
| RICHARD FONSECA JR3 | 737 BISHOP STREET, SUITE 2120 HONOLULU, HI 96813 | AFLAC | $615 | $0 | $615 | 1.08% |
| TENNYSON K W LUM JR3 | 1132 BISHOP ST., SUITE 2101 HONOLULU, HI 96813 | AFLAC | $463 | $114 | $577 | 1.01% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CO | 700 BISHOP ST., SUITE 1400 HONOLULU, HI 96813 | AFLAC | $530 | $0 | $530 | 0.93% |
| GALEN MIZUGUCHI3 | 101 AUPUNI STREET, SUITE 1001 A HILO, HI 96720 | AFLAC | $408 | $76 | $484 | 0.85% |
| PATTIE L ARANIO3 | 1136 UNION MALL STE 705 HONOLULU, HI 96813 | AFLAC | $351 | $0 | $351 | 0.61% |
| CALVIN L MALINA JR3 | 1888 KALAKAUA AVE, SUITE C312 334 HONOLULU, HI 96815 | AFLAC | $272 | $0 | $272 | 0.48% |
| JAMES ARTHUR HARBOUR3 Filed as: JAMES HARBOUR | 1100 ALAKEA STREET, SUITE 3200 HONOLULU, HI 96813 | AFLAC | $172 | $76 | $248 | 0.43% |
| JOSEPH REYNON JR3 | 91-284 HANAPOULI CIRCLE, APT C-7 EWA BEACH, HI 96706 | AFLAC | $156 | $0 | $156 | 0.27% |
| STEPHEN H ARANIO3 | 1136 UNION MALL STE 705 HONOLULU, HI 96813 | AFLAC | $149 | $0 | $149 | 0.26% |
| DERRICK A FUJIOKA3 | 91-1100 PUAHALA ST., APT S EWA BEACH, HI 96706 | AFLAC | $136 | $0 | $136 | 0.24% |
| GLEN M MIYAMOTO3 | PO BOX 62971 EWA BEACH, HI 96706 | AFLAC | $130 | $0 | $130 | 0.23% |
| MARIE BAYUDAN-DRURY3 | PO BOX 1195 HAIKU, HI 96708 | AFLAC | $93 | $0 | $93 | 0.16% |
| KAREN C ST ONGE3 | PO BOX 31231 HONOLULU, HI 96820 | AFLAC | $79 | $0 | $79 | 0.14% |
| BRONSON K SISMAR3 | 740 AHUKINI ST. HONOLULU, HI 96825 | AFLAC | $61 | $0 | $61 | 0.11% |
| PATRICIA S SAKAI3 | 320 EAST HIND DR HONOLULU, HI 96821 | AFLAC | $55 | $0 | $55 | 0.10% |
| CHRISTIAN FERMAHIN3 | 99-157 KEALAKAHA DR AIEA, HI 96701 | AFLAC | $53 | $0 | $53 | 0.09% |
| MARJORIE C ROBINSON3 | 91-1095 KAIKO ST EWA BEACH, HI 96706 | AFLAC | $52 | $0 | $52 | 0.09% |
| JAMES J TAVARES SR3 | 303 PUEO DR KULA, HI 96790 | AFLAC | $51 | $0 | $51 | 0.09% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AFLAC | $50 | $0 | $50 | 0.09% |
| ENROLLEASE3 Filed as: CLARKE T TERUYA | 1253 SOUTH BERETANIA ST., STE 2904 HONOLULU, HI 96814 | AFLAC | $42 | $0 | $42 | 0.07% |
| PERFECTO R INCIONG JR3 | 1136 UNION MALL STE 705 HONOLULU, HI 96813 | AFLAC | $31 | $0 | $31 | 0.05% |
| KYLE C KWOCK3 | 1667 KAUMOLI ST PEARL CITY, HI 96782 | AFLAC | $31 | $0 | $31 | 0.05% |
| RYAN M GOO3 Filed as: RYAN GOO | 1132 BISHOP STREET, SUITE 2101 HONOLULU, HI 96813 | AFLAC | $30 | $0 | $30 | 0.05% |
| WINIFRED W CHINEN3 | 2305 AHAANA WAY HONOLULU, HI 96821 | AFLAC | $27 | $0 | $27 | 0.05% |
| CONSTANCE M SERONIO3 | 92-713 PAAKAI ST KAPOLEI, HI 96707 | AFLAC | $16 | $0 | $16 | 0.03% |
| STEVEN KAISER3 | 4120 OLD BARK WAY CUMMING, GA 30041 | AFLAC | $14 | $0 | $14 | 0.02% |
| MICHAEL I ING3 | 363 KIKOO PL HONOLULU, HI 96825 | AFLAC | $14 | $0 | $14 | 0.02% |
| IRIS HARUE NAKAO3 Filed as: IRIS NAKAO | 95-1050 MAKAIKAI ST, APT 21C MILILANI, HI 96789 | AFLAC | $14 | $0 | $14 | 0.02% |
| CAIN K A KAMANO3 | PO BOX 1509 KANEOHE, HI 96744 | AFLAC | $13 | $0 | $13 | 0.02% |
| DOMINIC D PIAZZA3 | 1136 UNION MALL STE 705 HONOLULU, HI 96813 | AFLAC | $11 | $0 | $11 | 0.02% |
| LAURENE ORIDE3 | 3398 WINAM AVE HONOLULU, HI 96815 | AFLAC | $10 | $0 | $10 | 0.02% |
| MARLA S TAKAMORI3 | 877 ALA MOANA BLVD, STE 720 HONOLULU, HI 96813 | AFLAC | $8 | $0 | $8 | 0.01% |
| GALE KLY FENNA3 | 337-B1 KALAMA STREET KAILUA, HI 96734 | AFLAC | $6 | $0 | $6 | 0.01% |
| COLIN D FUKAMI3 | 98-1277 KAAHUMANU ST, 106-364 AIEA, HI 96701 | AFLAC | $5 | $0 | $5 | 0.01% |
| DUSTIN DEAN DENIZ3 | 222 LILIUOKALANI AVE APT 803 HONOLULU, HI 96815 | AFLAC | $5 | $0 | $5 | 0.01% |
| TINA GRAZIANO3 | 7461 OHANA NUI CIR, APT C HONOLULU, HI 96818 | AFLAC | $5 | $0 | $5 | 0.01% |
| JANICE TAKASAKI3 | 1812 KALAKAUA AVE, APT 530 HONOLULU, HI 96815 | AFLAC | $3 | $0 | $3 | 0.01% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP ST., SUITE 1400 HONOLULU, HI 96813 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 7.18% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP ST., SUITE 1400 HONOLULU, HI 96813 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 8.00% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP ST., SUITE 1400 HONOLULU, HI 96813 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $816 | $0 | $816 | 8.00% |
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 | 493 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 499 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 392 | $2.6M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 662 | $232K |
| Vision(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 392 | $2.6M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 480 | $71K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 653 | $43K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 480 | $39K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 392 | $2.6M |
| Other(2 contracts, 2 carriers) | AFLAC | 480 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 662 | — |
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.