Form 5500 · Employee benefit plan · HONOLULU, HI
LOCAL 665 I.A.T.S.E. HEALTH & WELFARE PLAN
LOCAL 665 I.A.T.S.E. HEALTH & WELFARE PLAN of HONOLULU, HI files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is BENEFIT PLAN SOLUTIONS, INC.. Coverage is written through UNIVERSITY HEALTH ALLIANCE and 4 other carriers. The plan's most recent policy period ended in June.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 99-0228405 · plan 501 · plan year 2025, filed Mar 11, 2026
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53 other employer plans in Hawaii have policy years ending in June. 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 plan's own financial statement reports paying insurance carriers about what the insurance contracts report in premium.
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 5 insured contracts covering health, dental, vision and life; the largest, with UNIVERSITY HEALTH ALLIANCE, covers 723 people.
Reported premium across the insured contracts is $4,942,171, with $59,133 in disclosed broker commissions — about 1.2% of premium.
The health contract's policy period ended in June, while at least one ancillary line's policy period ended in May. The plan is on a split renewal cycle.
BENEFIT PLAN SOLUTIONS, INC. is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including UNIVERSITY HEALTH ALLIANCE, KAISER FOUNDATION HEALTH PLAN OF HAWAII, HAWAII DENTAL SERVICE and VISION SERVICE PLAN. UNIVERSITY HEALTH ALLIANCE writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNIVERSITY HEALTH ALLIANCE | Health | 723 | Jul 1, 2024 | $3,556,538 | $59,133 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII | Health | 186 | Jul 1, 2024 | $1,119,986 | $0 |
| HAWAII DENTAL SERVICE | Dental | 776 | Jun 1, 2025 | $232,450 | $0 |
| VISION SERVICE PLAN | Vision | 316 | Jun 1, 2025 | $19,498 | $0 |
| PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. | Life | 369 | Jun 1, 2025 | $13,699 | $0 |
Premium and claims on these contracts
UNIVERSITY HEALTH ALLIANCE, contract 8432. For the contract year on this filing, the carrier reported $3,556,538 in premium earned and $2,418,232 in claims incurred. Dividing one by the other gives 68%.
VISION SERVICE PLAN, contract 30014658. For the contract year on this filing, the carrier reported $19,498 in premium earned and $15,406 in claims incurred. Dividing one by the other gives 79%.
- UNIVERSITY HEALTH ALLIANCE, contract 8432 reported $376,993 in retention.
- VISION SERVICE PLAN, contract 30014658 reported $4,290 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. The service providers are named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
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