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Form 5500 · Employee benefit plan · HONOLULU, HI

HI-SIC, INC.

HI-SIC, INC. of HONOLULU, HI insures health, dental, vision and life coverage for its employees, per Schedule A of its Form 5500. Its broker of record is TIMA-HIU TAMZEN. Coverage is written through KAISER FOUNDATION HEALTH PLAN OF HAWAII and 3 other carriers. The plan's most recent policy period ended in December.

Benefits broker of record
Insurance carrier
Plan renews
December

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 99-0313967 · plan 501 · as of Aug 2026

Participants
1,379
Carriers on file
4
Disclosed commissions
$4,361
Renewal month
December

Plan brief

Schedule A lists 4 insured contracts covering health, dental, vision and life; the largest, with KAISER FOUNDATION HEALTH PLAN OF HAWAII, covers 512 people.

Reported premium across the insured contracts is $7,093,720, with $4,361 in disclosed broker commissions — about 0.1% 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.

TIMA-HIU TAMZEN is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.

4 carriers appear on the filing — KAISER FOUNDATION HEALTH PLAN OF HAWAII, HAWAII DENTAL SERVICE, USABLE LIFE and HAWAII MEDICAL SERVICE ASSOCIATION — with KAISER FOUNDATION HEALTH PLAN OF HAWAII writing the largest contract by premium.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
USABLE LIFELife118December$118,021$3,125
HAWAII DENTAL SERVICEDental1,521December$2,695,353$1,236
HAWAII MEDICAL SERVICE ASSOCIATIONHealth, Vision89December$89,124$0
KAISER FOUNDATION HEALTH PLAN OF HAWAIIHealth, Vision512December$4,191,222$0

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