Form 5500 · Employee benefit plan · HONOLULU, HI
HONOLULU COMMUNITY ACTION PROGRAM
The filing calls this plan HONOLULU COMMUNITY ACTION PROGRAM'S HEALTH AND WELFARE PROGRAMS.
HONOLULU COMMUNITY ACTION PROGRAM of HONOLULU, HI is a 181-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is EMPLOYEE BEENFIT CONSULTING. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 2 other carriers. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 99-0140622 · plan 506 · plan year 2025, filed Mar 5, 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 3 insured contracts covering health, dental and vision; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 113 people.
Reported premium across the insured contracts is $1,936,598, with $57,921 in disclosed broker commissions — about 3% of premium.
The most recent policy period ended in July, and the plan year ends July 31. Group contracts typically renew on that annual cycle.
EMPLOYEE BEENFIT CONSULTING is the broker of record on all 3 contracts.
3 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., UNIVERSITY HEALTH ALLIANCE and HAWAII DENTAL SERVICE. KAISER FOUNDATION HEALTH PLAN, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNIVERSITY HEALTH ALLIANCE | Health, Vision | 81 | Aug 1, 2025 | $924,621 | $32,109 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health, Vision | 113 | Aug 1, 2025 | $925,437 | $24,946 |
| HAWAII DENTAL SERVICE | Dental | 222 | Aug 1, 2025 | $86,540 | $866 |
Premium and claims on this contract
UNIVERSITY HEALTH ALLIANCE, contract 1428. For the contract year on this filing, the carrier reported $924,621 in premium earned and $783,122 in claims incurred. Dividing one by the other gives 85%.
- UNIVERSITY HEALTH ALLIANCE, contract 1428 reported $91,260 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
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