| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCSWEENY INSURANCE & FINANCIAL SVCS3 | P.O. BOX 100 SEAL BEACH, CA 90740 | UNIVERSITY HEALTH ALLIANCE | $19K | — | $19K | 3.44% |
| KERSTEN, RICHARD IRA3 Filed as: KERSTEN, RICHARD | 900 FORT STREET, SUITE 500 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE | $19K | — | $19K | 10.00% |
| KERSTEN, RICHARD IRA3 | PIONEER PLAZA 900 FORT ST MALL, STE 500 HONOLULU, HI 96813 | NORTHWESTERN MUTUAL | $4K | $916 | $5K | 9.59% |
| THOMAS JOSEPH MCTIGUE3 | PIONEER PLAZA 900 FORT ST MALL STE 500 HONOLULU, HI 96813 | NORTHWESTERN MUTUAL | — | $157 | $157 | 0.31% |
| GARRETT J BLEAKLEY INS3 | ONE AMERICA PLAZA 600 W BROADWAY STE 600 SAN DIEGO, CA 92101 | NORTHWESTERN MUTUAL | — | $52 | $52 | 0.10% |
| RICHARD KERSTEN3 | 900 FORT STREET, SUITE 500 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE | $968 | — | $968 | 12.00% |
| RICHARD KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $127 | — | $127 | 7.52% |
| MARY M MATTOS3 Filed as: MARY MATTOS | APT A 355 HUALANI ST KAILUA, HI 96734 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $127 | — | $127 | 7.52% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $5 | $5 | 0.30% |
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 | 5,012 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 67 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,079 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 3 carriers) | UNIVERSITY HEALTH ALLIANCE | 2,841 | $28.6M |
| Dental(2 contracts) | HAWAII DENTAL SERVICE | 4,376 | $2.2M |
| Vision(6 contracts, 3 carriers) | UNIVERSITY HEALTH ALLIANCE | 2,841 | $28.1M |
| Life insurance(2 contracts) | PACIFIC GUARDIAN LIFE | 5,012 | $196K |
| Long-term disability | NORTHWESTERN MUTUAL | 159 | $51K |
| Prescription drug(7 contracts, 3 carriers) | UNIVERSITY HEALTH ALLIANCE | 2,841 | $28.6M |
| Other(3 contracts, 2 carriers) | PACIFIC GUARDIAN LIFE | 5,012 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,012 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.