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| Provider | Services | Address | Compensation |
|---|---|---|---|
| HAWAII DENTAL SERVICE EIN 99-0107971 CLAIMS PROCESSOR | Claims processing Service code 12 | 900 FORT STREET MALL SUITE 1900 HONOLULU, HI 96813 | $194K |
| STRAUB CLINIC & HOSPITAL EIN 91-2151670 SERVICE PROVIDER | Other services Service code 49 | 55 MERCHANT STREET 24TH FLOOR HONOLULU, HI 96813 | $74K |
| WORKLIFE HAWAII EIN 99-0073483 SERVICE PROVIDER | Other services Service code 49 | 91-1841 FORT WEAVER ROAD EWA BEACH, HI 96706 | $40K |
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 | 2,041 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 972 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,013 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 3,143 | $21.8M |
| Vision | VISION SERVICE PLAN | 2,366 | $277K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,608 | $914K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,030 | $318K |
| Prescription drug(4 contracts, 4 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 3,143 | $21.8M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,479 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,143 | — |
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.