| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCSWEENY INSURANCE & FINANCIAL SVCS3 | 79090 DIANA DRIVE LA QUINTA, CA 92253 | UNIVERSITY HEALTH ALLIANCE | $17K | — | $17K | 3.28% |
| RICHARD KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | RELIASTAR LIFE INSURANCE COMPANY | $45K | — | $45K | 20.00% |
| KERSTEN, RICHARD IRA3 | MAUKA TOWER 737 BISHOP ST STE 1700 HONOLULU, HI 96813 | NORTHWESTERN MUTUAL | $5K | $1K | $6K | 7.26% |
| JAMESON PAUL DELGADILLO3 | MAUKA TOWER 737 BISHOP ST, STE 1700 HONOLULU, HI 96813 | NORTHWESTERN MUTUAL | $483 | $174 | $657 | 0.79% |
| TOM STEWART IN SOL INC3 | ONE AMERICA PLAZA 600 W BROADWAY STE 600 SAN DIEGO, CA 92101 | NORTHWESTERN MUTUAL | $483 | $58 | $541 | 0.65% |
| MARY M MATTOS3 | 355 A HUALANI ST KAILUA, HI 96734 | HARTFORD LIFE AND ACCIDENT | $363 | $50 | $413 | 2.59% |
| RICHARD I KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | HARTFORD LIFE AND ACCIDENT | $363 | $30 | $393 | 2.47% |
| RICHARD KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $74 | — | $74 | 7.46% |
| MARY M MATTOS3 Filed as: MARY MATTOS | APT A 355 HUALANI ST KAILUA, HI 96734 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $74 | — | $74 | 7.46% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2 | $2 | 0.20% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1 | $1 | 0.10% |
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 | 6,521 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 132 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,653 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 2,687 | $39.0M |
| Dental(2 contracts) | HAWAII DENTAL SERVICE | 5,086 | $2.6M |
| Vision(5 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 2,687 | $38.5M |
| Life insurance(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 12,607 | $239K |
| Long-term disability | NORTHWESTERN MUTUAL | 200 | $83K |
| Prescription drug(6 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 2,687 | $39.0M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 12,607 | $240K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,607 | — |
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.