| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCSWEENY INSURANCE & FINANCIAL SVCS3 | 79090 DIANA DRIVE LA QUINTA, CA 92253 | UNIVERSITY HEALTH ALLIANCE | $23K | — | $23K | 3.21% |
| RICHARD KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | RELIASTAR LIFE INSURANCE COMPANY | $43K | — | $43K | 17.26% |
| KERSTEN, RICHARD IRA3 | MAUKA TOWER 737 BISHOP ST STE 1700 HONOLULU, HI 96813 | NORTHWESTERN MUTUAL | $5K | $1K | $6K | 7.74% |
| JAMESON PAUL DELGADILLO3 | MAUKA TOWER 737 BISHOP ST, STE 1700 HONOLULU, HI 96813 | NORTHWESTERN MUTUAL | $495 | $178 | $673 | 0.84% |
| TOM STEWART IN SOL INC3 | ONE AMERICA PLAZA 600 W BROADWAY STE 600 SAN DIEGO, CA 92101 | NORTHWESTERN MUTUAL | $495 | $59 | $554 | 0.69% |
| MARY M MATTOS3 | 355 A HUALANI ST KAILUA, HI 96734 | HARTFORD LIFE AND ACCIDENT | $531 | $35 | $566 | 2.85% |
| RICHARD I KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | HARTFORD LIFE AND ACCIDENT | $531 | $35 | $566 | 2.85% |
| RICHARD KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $80 | — | $80 | 7.55% |
| MARY M MATTOS3 Filed as: MARY MATTOS | APT A 355 HUALANI ST KAILUA, HI 96734 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $80 | — | $80 | 7.55% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $5 | $5 | 0.47% |
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 | 5,966 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 49 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,015 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 2,693 | $40.5M |
| Dental(2 contracts) | HAWAII DENTAL SERVICE | 4,963 | $2.8M |
| Vision(6 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 2,693 | $40.5M |
| Life insurance(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 5,966 | $268K |
| Long-term disability | NORTHWESTERN MUTUAL | 200 | $80K |
| Prescription drug(6 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 2,693 | $40.5M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 5,966 | $269K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,966 | — |
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.