| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PSH INSURANCE, INC.3 | 737 BISHOP ST., #2120 HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN, INC. | $13K | — | $13K | 3.37% |
| PSH INSURANCE, INC.3 | 737 BISHOP STREET, SUITE 2120 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $3K | — | $3K | 2.26% |
| LIANE CHONG3 | SUITE 222 765 AMANA ST HONOLULU, HI 96814 | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 12.87% |
| AMERICAN MUTUAL UNDERWRITERS LTD3 | SUITE 1000 1357 KAPIOLANI BLVD HONOLULU, HI 96814 | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 3.22% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | — | $77 | $77 | 0.10% |
| PSH INSURANCE, INC.3 | 737 BISHOP STREET, SUITE 2120 HONOLULU, HI 96813 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 5.09% |
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 | 266 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HMSA | 334 | $1.5M |
| Dental | HAWAII DENTAL SERVICE | 406 | $145K |
| Vision(3 contracts, 3 carriers) | HMSA | 334 | $1.5M |
| Life insurance | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 214 | $80K |
| Long-term disability | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 214 | $80K |
| Prescription drug(3 contracts, 3 carriers) | HMSA | 334 | $1.5M |
| Other | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 214 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 406 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.