| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $5K | — | $5K | 1.95% |
| MERCER HEALTH AND BENEFITS, LLC3 | 745 FORT STREET, SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $2K | — | $2K | 2.00% |
| DAVID A. MOLENAAR3 Filed as: DAVID A MOLENAAR | 1188 BISHOP ST STE 1708 HONOLULU, HI 96813 | NORTHWESTERN MUTUAL | $3K | $674 | $3K | 19.77% |
| THOMAS JOSEPH MCTIGUE3 Filed as: THOMAS JOSEPH MC TIGUE | PIONEER PLAZA 900 FORT ST MALL STE 500 HONOLULU, HI 96813 | NORTHWESTERN MUTUAL | $368 | $87 | $455 | 2.66% |
| GARRETT J BLEAKLEY INS3 | ONE AMERICAN PLAZA 600 W BROADWAY STE 600 SAN DIEGO, CA 92101 | NORTHWESTERN MUTUAL | $327 | $29 | $356 | 2.08% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | USABLE LIFE | $198 | — | $198 | 2.60% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | USABLE LIFE | $205 | — | $205 | 9.79% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | USABLE LIFE | $397 | — | $397 | 29.96% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | USABLE LIFE | $14 | — | $14 | 1.93% |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 111 | $992K |
| Dental | HAWAII DENTAL SERVICE | 227 | $91K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 111 | $992K |
| Life insurance(2 contracts) | USABLE LIFE | 6 | $6K |
| Long-term disability | NORTHWESTERN MUTUAL | 140 | $17K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 111 | $992K |
| Other(7 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 140 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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."
No prospect flags tripped on this filing.