| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $26K | — | $26K | 2.01% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $18K | — | $18K | 1.34% |
| CALVO'S INSURANCE UNDERWRITERS, INC3 | P.O. BOX FJ HAGATNA, GU 96932 | TOKIO MARINE PACIFIC INSURANCE LTD. | $23K | — | $23K | 2.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | HARTFORD LIFE AND ACCIDENT | $13K | — | $13K | 4.46% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC. | 201 MERCHANT STREET HONOLULU, HI 96813 | HARTFORD LIFE AND ACCIDENT | $8K | — | $8K | 2.97% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK INC. | 2122 KRATKY ROAD ST. LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 10.19% |
| DAVID A. MOLENAAR3 | 1188 BISHOP ST., SUITE 1708 HONOLULU, HI 96813 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 5.49% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $2K | — | $2K | 1.44% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC. | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | VISION SERVICE PLAN | $1K | — | $1K | 0.97% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $689 | $3K | 12.32% |
| ATLAS INSURANCE AGENCY, INC.3 | 1132 BISHOP STREET, SUITE 1600 HONOLULU, HI 96813 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 6.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | USABLE LIFE | $1K | — | $1K | 10.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | ZURICH AMERICAN INSURANCE COMPANY | $367 | — | $367 | 19.99% |
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 | 1,683 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,697 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 268 | $2.5M |
| Dental | TOKIO MARINE PACIFIC INSURANCE LTD. | 268 | $1.2M |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 1,298 | $1.4M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,683 | $284K |
| Short-term disability | USABLE LIFE | 33 | $10K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 471 | $21K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 268 | $2.5M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,429 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,683 | — |
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.