No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PACIFIC ADMINISTRATORS INC. EIN 99-0351671 NONE | Plan Administrator; Direct payment from the plan Service code 14 | — | $323K |
| WEINBERG, ROGER, ROSENFELD EIN 94-2458080 NONE | Legal; Direct payment from the plan Service code 29 | — | $24K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $17K |
| RAYMOND JAMES NONE | Investment management fees paid directly by plan Service code 51 | 1001 BISHOP STREET, SUITE 2920 HONOLULU, HI 96813 | $12K |
| YOSHIDA & ASSOCIATES EIN 99-0337282 NONE | Direct payment from the plan; Legal Service code 29 | — | $10K |
| FIRST HAWAIIAN BANK EIN 99-0034327 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $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 | 3,267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,267 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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.