Form 5500 · Employee benefit plan · HONOLULU, HI
FOODLAND SUPER MARKET, LTD
The filing calls this plan FOODLAND/FOOD PANTRY WELFARE PLAN.
FOODLAND SUPER MARKET, LTD of HONOLULU, HI files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MERCER HEALTH AND BENEFITS, LLC. Coverage is written through HAWAII MEDICAL SERVICE ASSOCIATION and 7 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 99-0068548 · plan 501 · plan year 2024, filed Aug 21, 2025
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
217 other employer plans in Hawaii have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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
Also declared: death benefits, other welfare.
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 11 insured contracts covering health, dental, vision, life and disability; the largest, with HAWAII MEDICAL SERVICE ASSOCIATION, covers 4,200 people.
Reported premium across the insured contracts is $37,540,564, with $354,129 in disclosed broker commissions — about 0.9% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
MERCER HEALTH AND BENEFITS, LLC is the broker of record on 5 of the 11 contracts; the rest name a different broker or none.
8 carriers appear on the filing, including HAWAII MEDICAL SERVICE ASSOCIATION, KAISER FOUNDATION HEALTH PLAN, INC., HAWAII DENTAL SERVICE and AFLAC. HAWAII MEDICAL SERVICE ASSOCIATION writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 1,123 | Jan 1, 2025 | $8,036,700 | $182,551 |
| AFLAC | Health | 612 | Jan 1, 2025 | $541,970 | $88,558 |
| METROPOLITAN LIFE INSURANCE COMPANY | Life | 2,742 | Jan 1, 2025 | $242,000 | $21,453 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Disability | 1,122 | Jan 1, 2025 | $174,825 | $20,861 |
| AFLAC | Health | 81 | Jan 1, 2025 | $63,668 | $18,497 |
| HAWAII DENTAL SERVICE | Dental | 4,503 | Jan 1, 2025 | $1,405,161 | $12,782 |
| AFLAC | Health | 44 | Jan 1, 2025 | $31,224 | $5,701 |
| VISION SERVICE PLAN | Vision | 2,808 | Jan 1, 2025 | $151,694 | $3,164 |
| AFLAC | Health | 9 | Jan 1, 2025 | $3,201 | $562 |
| HAWAII MEDICAL SERVICE ASSOCIATION | Health | 4,200 | Jan 1, 2025 | $26,824,976 | $0 |
| EMPLOYEE ASSISTANCE OF THE PACIFIC, LLC | — | 4,343 | Jan 1, 2025 | $65,145 | $0 |
Premium and claims on this contract
HAWAII DENTAL SERVICE, contract 816. For the contract year on this filing, the carrier reported $1,405,161 in premium earned and $1,198,422 in claims incurred. Dividing one by the other gives 85%.
- HAWAII DENTAL SERVICE, contract 816 reported $189,959 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.
Other plans filed by this employer
How this plan compares
Subscribers see how this compares with similar plans in Hawaii. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
Renewal calendar
217 other employer plans in Hawaii are January 1 renewals (policy year ends December).
Their policy years end in December, like this plan’s, so most renew January 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
Claude & ChatGPT
Look up records from Claude or ChatGPT
Add Form5500Lookup to Claude or ChatGPT and ask about any employer, broker or carrier in plain English. Lookups are free. Renewal lists, full books of business and exports are included with a subscription.
Building a list or a tool from these records? Match a list you already have from $29 per 1,000 records, or license the whole dataset as a weekly file for $499 a month. See both
More employer plans in Hawaii — largest plans, brokers, carriers and renewal months.