Form 5500 · Employee benefit plan · HONOLULU, HI
MAUI DIVERS OF HAWAII
The filing calls this plan MAUI DIVERS OF HAWAII - HEALTH PLANS.
Public Form 5500 records show how MAUI DIVERS OF HAWAII of HONOLULU, HI, a retail employer, structures its employee benefits. Its broker of record is ATLAS INSURANCE AGENCY, INC.. Coverage is written through UNIVERSITY HEALTH ALLIANCE and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 99-0198534 · plan 502 · plan year 2025, filed Jun 24, 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: 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 4 insured contracts covering health, dental, vision, life and disability; the largest, with UNIVERSITY HEALTH ALLIANCE, covers 80 people.
Reported premium across the insured contracts is $1,082,480, with $53,365 in disclosed broker commissions — about 4.9% 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.
ATLAS INSURANCE AGENCY, INC. is the broker of record on all 4 contracts.
4 carriers appear on the filing, including UNIVERSITY HEALTH ALLIANCE, KAISER FOUNDATION HEALTH PLAN OF HAWAII, HAWAII DENTAL SERVICE and THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA. UNIVERSITY HEALTH ALLIANCE writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNIVERSITY HEALTH ALLIANCE | Health, Vision | 80 | Jan 1, 2026 | $533,453 | $28,801 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII | Health, Vision | 54 | Jan 1, 2026 | $434,579 | $16,593 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 130 | Jan 1, 2026 | $47,263 | $6,292 |
| HAWAII DENTAL SERVICE | Dental | 155 | Jan 1, 2026 | $67,185 | $1,679 |
Premium and claims on this contract
UNIVERSITY HEALTH ALLIANCE, contract 7171. For the contract year on this filing, the carrier reported $533,453 in premium earned and $533,068 in claims incurred. Dividing one by the other gives 100%.
- UNIVERSITY HEALTH ALLIANCE, contract 7171 reported $52,118 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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