| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | — | $11K | 3.63% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 700 BISHOP STREET SUITE 1100 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $1K | $0 | $1K | 0.99% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN | PO BOX 850502 MINNEAPOLIS, MN 55485 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | $0 | $9K | 12.55% |
| TYLER K PANG3 Filed as: TYLER K. PANG | 2510 RAINBOW DRIVE HON, HI 96822 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 6.04% |
| SUSANNA Y. H. TRAN3 | 3030 ALA LLIMA STREET SUITE 202 HONOLULU, HI 96818 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 1.83% |
| SIMON E TAUTALA3 Filed as: SIMON E. TAUTALA | 1406 NORTH MAIN STREET SUITE 116 MERIDIAN, ID 83642 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 1.51% |
| GARRETT CURTIS HIRANAKA3 | 3705 WAIALAE AVENUE HONOLULU, HI 96817 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 1.46% |
| THOMAS SHO KHORANA3 | 462 LUAKINI STREET HONOLULU, HI 96817 | CONTINENTAL AMERICAN INSURANCE COMPANY | $334 | $0 | $334 | 0.45% |
| MARJORIE C ROBINSON3 Filed as: MARJORIE ROBINSON AND ASSOCIATES | 91-1095 KAIKO DRIVE EWA BEACH, HI 96706 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 700 FORT STREET SUITE 1100 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $6K | $0 | $6K | 9.26% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 700 FORT STREET SUITE 1100 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $4K | $0 | $4K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.35% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 745 FORT STREET SUITE 1100 HONOLULU, HI 96813 | HARTFORD LIFE AND ACCIDENT | $113 | $11 | $124 | 16.53% |
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 | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 383 | $3.7M |
| Dental | HAWAII DENTAL SERVICE | 474 | $133K |
| Vision | VISION SERVICE PLAN | 274 | $26K |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 332 | $60K |
| Long-term disability | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 233 | $39K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 383 | $3.7M |
| Other(4 contracts, 4 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 700 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 700 | — |
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.