| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP PLAN ADMINISTRATORS3 | 222 SOUTH VINEYARD STREET PH4 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $6K | — | $6K | 1.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP PLAN ADMINISTRATORS, INC. EIN 99-0187572 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Consulting (general) Service code 13 | 222 S. VINEYARD BLVD., PH 4 HONOLULU, HI 96813 | $270K |
| LEMKE, CHINEN & TANAKA, CPA, INC. EIN 99-0155373 NONE | Accounting (including auditing) Service code 10 | 500 ALA MOANA BLVD., SUITE 2-302 HONOLULU, HI 96813 | $48K |
| THE SEGAL COMPANY, INC EIN 94-1503999 NONE | Actuarial Service code 11 | 100 MONTGOMERY STREET SUITE 500 SAN FRANCISCO, CA 941044308 | $18K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Custodial (securities) Service code 19 | 999 BISHOP STREET, UNIT 2806 HONOLULU, HI 96813 | $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 | 566 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 580 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,441 | $6.1M |
| Dental | HAWAII DENTAL SERVICE | 1,438 | $499K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 1,441 | $6.1M |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 633 | $171K |
| Short-term disability | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 633 | $171K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 1,441 | $6.1M |
| Stop-loss / reinsurancereinsurance | HAWAII MEDICAL SERVICE ASSOCIATION | 1,441 | $6.1M |
| Other | KAISER FOUNDATION HEALTH PLAN, INC. | 199 | $832K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,441 | — |
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.