Form 5500 · Employee benefit plan · HONOLULU, HI
IRONGATE WAIKIKI LLC DBA KA LA'I WAIKIKI BEACH
The filing calls this plan IRONGATE WAIKIKI LLC DBA KA LA'I WAIKIKI BEACH HEALTH & WELFARE PLAN.
IRONGATE WAIKIKI LLC DBA KA LA'I WAIKIKI BEACH of HONOLULU, HI is a 194-participant hospitality and food service employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is MERCER HEALTH AND BENEFITS, LLC. Coverage is written through HAWAII MEDICAL ASSURANCE ASSOCIATION and 5 other carriers. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 93-4923055 · plan 501 · plan year 2025, filed Jun 3, 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
Also declared: prepaid legal, 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 6 insured contracts covering health, dental, vision, life and disability; the largest, with HAWAII MEDICAL ASSURANCE ASSOCIATION, covers 296 people.
Reported premium across the insured contracts is $2,098,619, with $81,078 in disclosed broker commissions — about 3.9% of premium.
The most recent policy period ended in July, 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 4 of the 6 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including HAWAII MEDICAL ASSURANCE ASSOCIATION, KAISER FOUNDATION HEALTH PLAN, INC., HAWAII DENTAL SERVICE and AFLAC. HAWAII MEDICAL ASSURANCE ASSOCIATION writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HAWAII MEDICAL ASSURANCE ASSOCIATION | Health, Vision | 296 | Aug 1, 2025 | $1,653,058 | $49,186 |
| AFLAC | Dental, Vision, Life, Disability | 79 | Aug 1, 2025 | $89,649 | $19,595 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health, Vision | 33 | Aug 1, 2025 | $180,185 | $6,174 |
| HAWAII DENTAL SERVICE | Dental | 330 | Aug 1, 2025 | $129,370 | $3,228 |
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 205 | Aug 1, 2025 | $46,106 | $2,872 |
| PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | — | 1 | Aug 1, 2025 | $251 | $23 |
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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