| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 Filed as: AON RISK SERVICES, INC. OF HAWAII | 201 MERCHANT STREET STE 2400 HONOLULU, HI 96813 | HAWAII MEDICAL SERVICE ASSOCIATION | — | $19K | $19K | 2.18% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY, INC | 201 MERCHANT STREET STE 1100 HONOLULU, HI 96813 | HAWAII MEDICAL SERVICE ASSOCIATION | — | $7K | $7K | 0.82% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES, INC. OF HAWAII | 201 MERCHANT STREET STE 2400 HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 2.40% |
| ATLAS INSURANCE AGENCY, INC.3 | 201 MERCHANT STREET STE 1100 HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN INC | $1K | — | $1K | 0.74% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES, INC. OF HAWAII | 201 MERCHANT STREET STE 2400 HONOLULU, HI 96813 | USABLE LIFE | $6K | — | $6K | 10.91% |
| ATLAS INSURANCE AGENCY, INC.3 | 201 MERCHANT STREET STE 1100 HONOLULU, HI 96813 | USABLE LIFE | $869 | — | $869 | 1.69% |
| LUTZ, DANIEL3 | PO BOX 860 HONOLULU, HI 96808 | USABLE LIFE | $773 | — | $773 | 1.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 700 BISHOP ST. 14TH FLOOR SUITE 1400 HONOLULU, HI 96813 | USABLE LIFE | -$1K | — | -$1K | -2.59% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 700 BISHOP ST. 14TH FLOOR SUITE 1400 HONOLULU, HI 96813 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $449 | $507 | $956 | 8.23% |
| ATLAS INSURANCE AGENCY, INC.3 | 201 MERCHANT STREET STE 1100 HONOLULU, HI 96813 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $312 | — | $312 | 2.69% |
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 | 195 | 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) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 355 | $1.0M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 355 | $881K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 355 | $1.0M |
| Life insurance | USABLE LIFE | 112 | $52K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 69 | $12K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 355 | $1.0M |
| Other | USABLE LIFE | 112 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 355 | — |
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.