| Provider | Services | Address | Compensation |
|---|---|---|---|
| PACIFIC ADMINISTRATORS INC EIN 99-0351671 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $1.7M |
| CODY KAWCZYNSKI EIN 99-6014749 EMPLOYEE OF PLAN | Employee (plan); Direct payment from the plan Service code 30 | — | $110K |
| MILLIMAN EIN 91-0675641 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $108K |
| HAWAII DENTAL SERVICE EIN 99-0107971 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $102K |
| RENALOGIC EIN 22-3857341 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $80K |
| UBS FINANCIAL SERVICES INC EIN 13-2638166 NONE | Other fees; Investment management fees paid directly by plan; Distribution (12b-1) fees Service code 51 | — | $78K |
| CATAMARAN EIN 11-2581812 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $47K |
| HEMMING MORSE EIN 30-0702322 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $44K |
| FOCUS INVESTMENT ADVISORS EIN 33-0606466 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $42K |
| WEINBERG, ROGER, & ROSENFELD EIN 94-2458080 NONE | Legal; Direct payment from the plan Service code 29 | — | $41K |
| YOSHIDA AND ASSOCIATES EIN 99-0337282 NONE | Legal; Direct payment from the plan Service code 29 | — | $41K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $39K |
| CENTRAL PACIFIC BANK EIN 39-2068708 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $29K |
| HEALTHENTIC NONE | Consulting (general); Direct payment from the plan Service code 16 | 9706 4TH AVE. NE, SUITE 208 SEATTLE, WA 98115 | $15K |
| BANK OF HAWAII EIN 99-0210467 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $10K |
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 | 2,990 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 774 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,764 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 740 | $1.8M |
| Dental(2 contracts, 2 carriers) | HAWAII DENTAL SERVICE | 875 | $409K |
| Life insurance(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE COMPANY | 3,743 | $1.1M |
| Short-term disability | PACIFIC GUARDIAN LIFE INSURANCE CO. | 2,790 | $525K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,743 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.