| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER | $0 | $0 | $0 | 0.00% |
| GROUP PLAN ADMINISTRATORS3 Filed as: GROUP PLAN ADMINISTRATORS, INC. | 222 SOUTH VINEYARD ST. PH4 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $4K | — | $4K | 2.24% |
| GROUP PLAN ADMINISTRATORS3 | 222 SOUTH VINEYARD ST. PH4 HONOLULU, HI 96813 | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | $2K | $0 | $2K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP PLAN ADMINISTRATORS, INC. EIN 99-0187572 NONE | Consulting (general); Plan Administrator Service code 14 | 222 SOUTH VINEYARD ST. PH4 HONOLULU, HI 96813 | $83K |
| G. USHIJIMA CPA LLC EIN 20-1318913 NONE | Accounting (including auditing) Service code 10 | 1110 UNIVERSITY AVENUE STE508 HONOLULU, HI 96826 | $7K |
| BANK OF HAWAII EIN 99-0229952 NONE | Investment management fees paid directly by plan Service code 51 | 111 SOUTH KING STREET HONOLULU, HI 96813 | $5K |
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 | 228 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HMSA | 49 | $1.5M |
| Dental | HAWAII DENTAL SERVICE | 550 | $187K |
| Vision | HMSA | 49 | $1.5M |
| Life insurance | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 346 | $47K |
| Prescription drug | HMSA | 49 | $1.5M |
| Stop-loss / reinsurancereinsurance | HMSA | 49 | $1.5M |
| Other | PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | 346 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 550 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.