| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS RESOURCE, INC.3 | 700 BISHOP STREET, SUITE 502 HONOLULU, HI 96813 | HMAA | $32K | $0 | $32K | 2.89% |
| EMPLOYEE BENEFITS RESOURCE, INC.3 | 700 BISHOP STREET, SUITE 502 HONOLULU, HI 96813 | KAISER PERMANENTE | $10K | $0 | $10K | 3.60% |
| EMPLOYEE BENEFITS RESOURCE, INC.3 | 700 BISHOP STREET, SUITE 502 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $2K | $0 | $2K | 2.00% |
| RICHARD KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | THE HARTFORD | $4K | $0 | $4K | 12.60% |
| MARY M MATTOS3 Filed as: MARY MATTOS | 355 HUALANI STREET, APT A KAILUA, HI 96734 | THE HARTFORD | $809 | $0 | $809 | 2.40% |
| RICHARD KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 15.00% |
| RICHARD KERSTEN3 | 900 FORT STREET, SUITE 500 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE | $2K | $0 | $2K | 9.87% |
| RICHARD KERSTEN3 | 900 FORT STREET, SUITE 500 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE | $1K | $3 | $1K | 9.89% |
| RICHARD KERSTEN3 | 458 AULIMA LOOP KAILUA, HI 96734 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $649 | $0 | $649 | 9.99% |
| RICHARD KERSTEN3 | 900 FORT STREET, SUITE 500 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE | $233 | $0 | $233 | 10.20% |
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 | 281 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HMAA | 284 | $1.4M |
| Dental | HAWAII DENTAL SERVICE | 228 | $110K |
| Vision(2 contracts, 2 carriers) | HMAA | 284 | $1.4M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $33K |
| Short-term disability(3 contracts) | PACIFIC GUARDIAN LIFE | 158 | $40K |
| Long-term disability | THE HARTFORD | 94 | $34K |
| Prescription drug(2 contracts, 2 carriers) | HMAA | 284 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.