| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BTP HEALTH LLC | 87-1127 OHEOHE STREET WAIANAE, HI 96792 | HMAA | $32K | — | $32K | 2.98% |
| HAWAII PASIFIKA LLC3 Filed as: HAWAII-WESTERN ADVISORY SERVICES | 737 BISHOP STREET, SUITE 1510 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $829 | — | $829 | 0.50% |
| ATLAS INSURANCE AGENCY, INC.3 | 1132 BISHOP STREET, SUITE 1600 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $698 | — | $698 | 0.42% |
| ATLAS INSURANCE AGENCY, INC. | 1132 BISHOP STREET, SUITE 1600 HONOLULU, HI 96813 | CIGNA GROUP INSURANCE | $3K | — | $3K | 13.66% |
| NONE | — | DENTAL CARE CENTERS OF HAWAII | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HAWAII BENEFIT ADMINISTRATORS, INC EIN 99-6005504 NONE | Contract Administrator; Direct payment from the plan Service code 13 | 200 N. VINEYARD BLVD., SUITE 100 HONOLULU, HI 96817 | $130K |
| HAWAII WESTERN ADVISORY SERVICES NONE | Consulting (general); Insurance brokerage commissions and fees; Direct payment from the plan Service code 16 | 737 BISHOP STREET 1510 HONOLULU, HI 96813 | $25K |
| ENVISION NONE | Direct payment from the plan; Claims processing Service code 12 | 2181 E. AURORA ROAD TWINSBURG, OH 44087 | $20K |
| JAMES P HASSELMAN CPA LLC EIN 20-5496781 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | P.O. BOX 11149 HONOLULU, HI 96828 | $19K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Direct payment from the plan; Investment management; Investment management fees paid indirectly by plan; Custodial (securities) Service code 19 | 999 BISHOP STREET HONOLULU, HI 96813 | $18K |
| RAYMOND JAMES & ASSOCIATES, INC NONE | Investment advisory (plan); Direct payment from the plan; Investment management fees paid indirectly by plan Service code 27 | 1001 BISHOP STREET, SUITE 2920 HONOLULU, HI 96813 | $7K |
| ACW INSURANCE NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | 1000 BISHOP STREET HONOLULU, HI 96813 | $6K |
| WEINBERG, ROGER & ROSENFELD EIN 94-2458080 NONE | Legal; Direct payment from the plan Service code 29 | — | $6K |
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 | 239 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HMAA | 405 | $1.8M |
| Dental(2 contracts, 2 carriers) | HAWAII DENTAL SERVICE | 577 | $167K |
| Life insurance | CIGNA GROUP INSURANCE | 221 | $23K |
| Other | CIGNA GROUP INSURANCE | 221 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 577 | — |
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.