| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 COMMISSION LOCKBOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $19K | — | $19K | 0.92% |
| FIRST HAWAIIAN BANK1 | 999 BISHOP ST., STE 1850 HONOLULU, HI 96813 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $61K | — | $61K | 5.91% |
| AGIS NETWORK INC3 | 2122 KRATKY RD ST LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $45K | — | $45K | 4.43% |
| BENEFITS HAWAII LLC3 | STE 1708 1188 BISHOP ST HONOLULU, HI 96813 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $45K | — | $45K | 4.43% |
| FIRST HAWAIIAN BANK1 | PO BOX 3200 HONOLULU, HI 96847 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $66K | — | $66K | 12.37% |
| BENCHMARK INS GROUP LLC3 | PO BOX 470845 CHARLOTTE, NC 28247 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 1.14% |
| CALVO'S INSURANCE UNDERWRITERS, INC3 | PO BOX FJ HAGATNA, GU 96932 | TOKIO MARINE PACIFIC INSURANCE LTD. | $9K | — | $9K | 2.00% |
| FIRST HAWAIIAN BANK1 | PO BOX 3200 HONOLULU, HI 96847 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $38K | — | $38K | 14.40% |
| BENCHMARK INS GROUP LLC3 | P BOX 470845 CHARLOTTE, NC 28247 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 1.39% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HAWAII DENTAL SERVICE EIN 99-0107971 CLAIMS PROCESSOR | Claims processing Service code 12 | 700 BISHOP STREET SUITE 700 HONOLULU, HI 96813 | $165K |
| STRAUB CLINIC & HOSPITAL EIN 91-2151670 SERVICE PROVIDER | Other services Service code 49 | 55 MERCHANT STREET, 24TH FLOOR HONOLULU, HI 96813 | $104K |
| WORKLIFE HAWAII EIN 99-0073483 SERVICE PROVIDER | Other services Service code 49 | 1001 BISHOP STREET STE 780 HONOLULU, HI 96813 | $38K |
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 | 2,132 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 698 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,830 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | HAWAI'I MEDICAL SERVICE ASSOCIATION | 3,263 | $16.6M |
| Prescription drug(4 contracts, 4 carriers) | HAWAI'I MEDICAL SERVICE ASSOCIATION | 3,263 | $16.6M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,918 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,263 | — |
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.