| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BTP HEALTH LLC3 | 87-1127 OHEOHE ST. WAIANAE, HI 96792 | HAWAII MEDICAL ASSURANCE ASSOCIATION | — | $33K | $33K | 3.09% |
| BENEFIT PLAN SOLUTIONS, INC.3 | 680 IWILEI STREET, SUITE 528 HONOLULU, HI 96817 | HAWAII DENTAL SERVICE | $1K | — | $1K | 1.04% |
| BENEFIT PLAN SOLUTIONS, INC.3 | 680 IWILEI STREET, SUITE 528 HONOLULU, HI 96817 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 6.00% |
| BENEFIT PLAN SOLUTIONS, INC.3 | 680 IWILEI STREET, SUITE 528 HONOLULU, HI 96817 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 10.68% |
| BENEFIT PLAN SOLUTIONS, INC.3 | 680 IWILEI STREET, SUITE 528 HONOLULU, HI 96817 | HAWAII DENTAL SERVICE | $33 | — | $33 | 1.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PACIFIC ADMINISTRATORS, INC. EIN 99-0351671 NONE | Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 10 | 1440 KAPIOLANI BLVD, STE 800 HONOLULU, HI 96814 | $63K |
| BENEFIT PLAN SOLUTIONS, INC. EIN 99-0114097 NONE | Consulting (general) Service code 16 | 681 IWILEI ROAD, STE 528 HONOLULU, HI 96817 | $49K |
| LEMKE, CHINEN & TANAKA, C.P.A., INC EIN 99-1055373 NONE | Accounting (including auditing) Service code 10 | 500 ALA MOANA BLVD, SUITE 2-302 HONOLULU, HI 96813 | $21K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Investment management; Custodial (securities) Service code 19 | 999 BISHOP STREET, SUITE 2806 HONOLULU, HI 96811 | $20K |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 360 | $1.1M |
| Dental(2 contracts) | HAWAII DENTAL SERVICE | 380 | $126K |
| Short-term disability | PACIFIC GUARDIAN LIFE INSURANCE COMPANY | 118 | $34K |
| Prescription drug(2 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 360 | $1.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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.