| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST FLORIDA INSURERS OF TAMPA INC | 3710 CORPOREX PARK DRIVE, SUITE 215 TAMPA, FL 33619 | ENVISION INSURANCE COMPANY | $23K | — | $23K | 7.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HAWAII MEDICAL SERVICE ASSOCIATION EIN 99-0040115 NONE | Claims processing Service code 12 | P.O. BOX 860 HONOLULU, HI 96808 | $684K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Actuarial; Consulting (general); Accounting (including auditing) Service code 10 | 100 MONTGOMERY STREET, SUITE 500 SAN FRANCISCO, CA 94104 | $342K |
| PAMCAH-UA LOCAL 675 ADMIN OFFICE EIN 99-0110375 ADMIN OFFICE | Plan Administrator Service code 14 | 1109 BETHEL STREET, ROOM 403 HONOLULU, HI 96813 | $335K |
| ENVISION PHARMACEUTICAL SERVICES EIN 20-4308924 NONE | Claims processing Service code 12 | 2181 EAST AURORA ROAD 201 TWINSBURG, OH 44087 | $180K |
| HAWAII DENTAL SERVICE EIN 99-0107971 NONE | Claims processing Service code 12 | 700 BISHOP STREET 700 HONOLULU, HI 96813 | $167K |
| CHAR, SAKAMOTO, ISHII, LUM & CHING EIN 99-0268206 NONE | Legal Service code 29 | 841 BISHOP STREET 850 HONOLULU, HI 96813 | $63K |
| LEMKE, CHINEN & TANAKA, C.P.A., INC EIN 99-0155373 NONE | Accounting (including auditing) Service code 10 | 500 ALA MOANA BLVD, SUITE 2-302 HONOLULU, HI 96813 | $51K |
| ROBECO INVESTMENT MANAGEMENT EIN 98-0202744 NONE | Investment management Service code 28 | 900 FORT STREET MALL, SUITE 905 HONOLULU, HI 96813 | $41K |
| NATIONAL BENEFITS ADMINISTRATORS EIN 99-0305497 NONE | Contract Administrator Service code 13 | 707 RICHARDS STREET PH6 HONOLULU, HI 96813 | $35K |
| VSP EIN 99-0247673 NONE | Claims processing Service code 12 | 1003 BISHOP STREET, SUITE 890 HONOLULU, HI 96813 | $33K |
| PACIFIC INCOME ADVISORS EIN 95-4067974 NONE | Investment management Service code 28 | 1299 OCEAN AVENUE SANTA MONICA, CA 90401 | $28K |
| CKW FINANCIAL GROUP EIN 27-1156797 NONE | Securities brokerage commissions and fees; Investment management fees paid directly by plan Service code 51 | 1003 BISHOP STREET, 1950 HONOLULU, HI 96813 | $19K |
| PACIFIC PROPERTY GROUP, INC. EIN 20-8525112 NONE | Other services Service code 49 | 1150 S. KING STREET, SUITE 501 HONOLULU, HI 96814 | $19K |
| CENTRAL PACIFIC BANK EIN 99-0309010 NONE | Custodial (securities) Service code 19 | P.O. BOX 1400 HONOLULU, HI 96807 | $15K |
| CONGRESS ASSET MANAGEMENT EIN 04-2848965 NONE | Investment management Service code 28 | 2 SEAPORT LANE BOSTON, MA 02210 | $15K |
| ABM ONSITE SERVICES EIN 22-3640690 NONE | Other services Service code 49 | — | $13K |
| STAR PROTECTION AGENCY, LLC. EIN 99-0292275 NONE | Other services Service code 49 | 3375 KOAPAKA STREET, SUITE B-217 HONOLULU, HI 96819 | $8K |
| SAMUEL FUJIKAWA TRUSTEE | Trustee (individual) Service code 20 | 2146 PUUHALE PLACE HONOLULU, HI 96819 | $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 | 1,650 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 327 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,977 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 238 | $342K |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE CO. | 1,650 | $464K |
| Prescription drug | ENVISION INSURANCE COMPANY | 241 | $316K |
| Other | ENVISION INSURANCE COMPANY | 241 | $316K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,650 | — |
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.