Form 5500 · Employee benefit plan · HONOLULU, HI
C. S. WO & SONS, LLC.
The filing calls this plan HEALTH AND WELLNESS PLAN FOR EMPLOYEES OF C. S. WO & SONS, LLC.
C. S. WO & SONS, LLC. of HONOLULU, HI files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is PSH INSURANCE INC. Coverage is written through KAISER FOUNDATION HEALTH PLAN OF HAWAII and 3 other carriers. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 99-0063065 · plan 507 · plan year 2025, filed Jun 13, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 4 insured contracts covering health, dental, vision and life; the largest, with KAISER FOUNDATION HEALTH PLAN OF HAWAII, covers 128 people.
Reported premium across the insured contracts is $1,662,823, with $42,183 in disclosed broker commissions — about 2.5% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
PSH INSURANCE INC is the broker of record on all 4 contracts.
4 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN OF HAWAII, HAWAII MEDICAL SERVICE ASSOCIATION, HAWAII DENTAL SERVICE and STANDARD INSURANCE COMPANY. KAISER FOUNDATION HEALTH PLAN OF HAWAII writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII | Health, Vision | 128 | Oct 1, 2025 | $1,054,376 | $36,918 |
| HAWAII MEDICAL SERVICE ASSOCIATION | Health, Vision | 43 | Oct 1, 2025 | $519,611 | $2,613 |
| STANDARD INSURANCE COMPANY | Life | 186 | Oct 1, 2025 | $17,830 | $1,354 |
| HAWAII DENTAL SERVICE | Dental | 245 | Oct 1, 2025 | $71,006 | $1,298 |
Premium and claims on this contract
STANDARD INSURANCE COMPANY, contract 173019. For the contract year on this filing, the carrier reported $17,830 in premium earned and $3,506 in claims incurred. Dividing one by the other gives 20%.
- STANDARD INSURANCE COMPANY, contract 173019 reported $14,321 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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