| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | UNIVERSITY HEALTH ALLIANCE | $13K | — | $13K | 5.18% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $9K | — | $9K | 3.94% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $618 | — | $618 | 3.50% |
| ATLAS INSURANCE AGENCY, INC.3 Filed as: ATLAS INSURANCE AGENCY | 201 MERCHANT STREET, SUITE 1100 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $406 | — | $406 | 9.99% |
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 | 17 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 26 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 12 | $492K |
| Dental | HAWAII DENTAL SERVICE | 32 | $18K |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 12 | $492K |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 11 | $4K |
| Prescription drug(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 12 | $492K |
| Other | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 11 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 32 | — |
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.