| 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 | $34K | — | $34K | 3.13% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | USABLE LIFE | $29K | — | $29K | 10.00% |
| DEBORAH NISHIJO3 | PO BOX 860 HONOLULU, HI 96808 | USABLE LIFE | $2K | — | $2K | 0.51% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADV | 12647 ALCOSTA BLVD STE 330 SAN RAMON, CA 94583 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 9.49% |
| DAVID A. MOLENAAR3 | 1188 BISHOP ST., SUITE 1708 HONOLULU, HI 96813 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 5.11% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRIVNE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | — | $15K | 10.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $2K | — | $2K | 2.41% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC. | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | VISION SERVICE PLAN | $34 | — | $34 | 0.04% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY INC. | 1820 E. 1ST STREET, SUITE 400 SANTA ANA, CA 92705 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.93% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRIVNE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $67 | $2K | 4.58% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC. | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40 | — | $40 | 0.12% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $179 | $4K | 15.24% |
| ATLAS INSURANCE AGENCY, INC.3 | 1132 BISHOP STREET, SUITE 1600 HONOLULU, HI 96813 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $120 | — | $120 | 0.48% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUTE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $75 | $2K | 7.08% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY INC. | 1820 E. 1ST STREET, SUITE 400 SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $673 | — | $673 | 3.04% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC. | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.12% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | HARTFORD LIFE AND ACCIDENT | $688 | $917 | $2K | 14.00% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY INC. | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | HARTFORD LIFE AND ACCIDENT | $458 | — | $458 | 4.00% |
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 | 1,072 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,075 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 142 | $1.1M |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 960 | $1.2M |
| Life insurance(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,081 | $186K |
| Short-term disability | USABLE LIFE | 994 | $293K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 381 | $25K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 142 | $1.1M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,249 | $258K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,249 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.