| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER FOUNDATION HEALTH PLAN OF HAWAII | — | — | $0 | 0.00% |
| NONE | — | HAWAII DENTAL SERVICE | — | — | $0 | 0.00% |
| NONE | — | HMSA BLUE CROSS/BLUE SHIELD | — | — | $0 | 0.00% |
| NONE | — | PACIFIC GUARDIAN LIFE INSURANCE CO | — | — | $0 | 0.00% |
| NONE | — | PACIFIC GUARDIAN LIFE INSURANCE CO | — | — | $0 | 0.00% |
| NONE | — | DENTAL CARE CENTERS OF HAWAII | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HAWAII MEDICAL SERVICE ASSOCATION EIN 99-0040115 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $1.1M |
| HAWAII BENEFIT ADMINISTRATORS, INC. EIN 99-0329747 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $503K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $125K |
| RAYMOND JAMES & ASSOCATES, INC NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | 1001 BISHOP STREET, SUITE 2920 HONOLULU, HI 96813 | $109K |
| BENEFIT PLAN SOLUTIONS, INC. EIN 20-5370318 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $101K |
| JAMES P. HASSELMAN CPA, LLC EIN 20-5496781 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $50K |
| FOCUS INVESTMENTS NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | 511 SAXONY PLACE, SUITE 101 ENCINITAS, CA 92024 | $46K |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Employee (plan); Claims processing Service code 12 | — | $23K |
| SEGAL NONE | Direct payment from the plan; Actuarial Service code 11 | 10880 WILSHIRE BLVD, SUITE 850 LOS ANGELES, CA 90024 | $14K |
| DECARLO & SHANLEY EIN 95-4022565 NONE | Legal; Direct payment from the plan Service code 29 | — | $12K |
| LAW OFFICE OF JEFFREY P. MILLER NONE | Legal; Direct payment from the plan Service code 29 | 733 BISHOP STREET, SUITE 2950 HONOLULU, HI 96813 | $10K |
| THE WAGNER LAW GROUP NONE | Direct payment from the plan; Consulting (general) Service code 16 | 300 MONTGOMERY STREET, SUITE 600 SAN FRANCISCO, CA 94104 | $9K |
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 | 3,670 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 374 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 96 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 2,161 | $11.2M |
| Dental(2 contracts, 2 carriers) | HAWAII DENTAL SERVICE | 10,164 | $3.5M |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE CO | 4,060 | $524K |
| Short-term disability | PACIFIC GUARDIAN LIFE INSURANCE CO | 3,913 | $892K |
| Prescription drug | HMSA BLUE CROSS/BLUE SHIELD | 577 | $2.1M |
| Other | PACIFIC GUARDIAN LIFE INSURANCE CO | 4,060 | $524K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,164 | — |
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.