| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | UNIVERSITY HEALTH ALLIANCE | $15K | $0 | $15K | 1.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY ROAD SUITE 200 SAN DIEGO, CA 92121 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $28K | $0 | $28K | 3.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY ROAD SUITE 200 SAN DIEGO, CA 92121 | HAWAII DENTAL SERVICE | $2K | $0 | $2K | 2.01% |
| RUSSELL A. HAYASHI3 Filed as: RUSSELL A. HAYASHI AND OTHER AGENTS | PO BOX 20 PEPEEKEO, HI 96783 | AFLAC | $4K | $254 | $5K | 5.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $3K | $0 | $3K | 4.42% |
| JACQUELYN E. K. HOLDER3 | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $2K | $115 | $2K | 2.34% |
| JACK DANIEL HOLDER3 | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $1K | $76 | $1K | 1.79% |
| TYLER K PANG3 Filed as: TYLER K. PANG | 1108 20TH AVENUE HONOLULU, HI 96816 | AFLAC | $851 | $13 | $864 | 1.11% |
| DEAN TAKASHI YONESHIGE3 | 1430 ALA HAHANUI STREET HONOLULU, HI 96818 | AFLAC | $737 | $66 | $803 | 1.03% |
| INC3 | 8220 UNIVERSITY AVENUE, SUITE 200 LA MESA, CA 91942 | AFLAC | $607 | $0 | $607 | 0.78% |
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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 159 | $1.7M |
| Dental | HAWAII DENTAL SERVICE | 346 | $102K |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 159 | $1.7M |
| Life insurance | AFLAC | 102 | $78K |
| Short-term disability | AFLAC | 102 | $78K |
| Prescription drug(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 159 | $1.7M |
| Other | AFLAC | 102 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 346 | — |
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.