Filings through .
History & trajectory Charts need 2 or more years. This plan has 10 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingNo prospect flags tripped on this filing.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Broker: Marsh & McLennan Agency LLC Life | Life |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 4 contracts with Pro. Pro is free for 7 days and then costs $49 a month.
These benefits are declared on the Form 5500 main form. A ✓ means the benefit also has a Schedule A insurance contract. Without one, plan assets or a Schedule C TPA fund the benefit.
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5,669 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,669 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(4 contracts) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 2,081 | $597K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,081 | - |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool instead of this filer's headcount. We show the row, but it does not count the people in this plan.
Brokers paid through Schedule A and service providers paid through Schedule C.
| Broker | Commissions |
|---|---|
Carrier: Hartford Life and Accident Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS CO EIN 59-1031071 THIRD-PARTY ADMINISTRATO | Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Participant communication; Claims processing; Non-monetary compensation; Direct payment from the plan; Other services; Contract Administrator Service code 12 | — | $154K |
| WILLIS TOWERS WATSON EIN 26-0775680 HRA ADMINISTRATION | Other fees; Other services; Direct payment from the plan Service code 49 | — | $98K |
| KPMG LLP EIN 13-5565207 PLAN AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $87K |
| BLACKROCK FINANCIAL MANAGEMENT, INC EIN 13-3806691 INVESTMENT MANAGER | Investment management; Investment advisory (plan); Investment management fees paid directly by plan; Direct payment from the plan Service code 27 | — | $64K |
| KAISER FOUNDATION HEALTH PLAN OF HI EIN 94-1340523 THIRD-PARTY ADMINISTRATO | Other services; Direct payment from the plan; Claims processing; Recordkeeping fees; Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $60K |
| EY EIN 34-6565596 TAX FORM PREPARER | Direct payment from the plan; Consulting (general) Service code 16 | — | $28K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 PLAN TRUSTEE | Trustee (directed); Account maintenance fees; Float revenue; Other fees; Other investment fees and expenses; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $26K |
| AON CONSULTING, INC. EIN 22-2232264 FORM 5500 PREP & ACTUARI | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $15K |
| GENERAL DYNAMICS INF TECHNOLOGY INC EIN 54-1194322 OBIEE COST ALLOCATION | Other fees; Direct payment from the plan; Other services Service code 49 | — | $14K |
| CROWE LLP EIN 35-0921680 FINANCIAL STATEMENT PREP | Direct payment from the plan; Accounting (including auditing); Consulting (general) Service code 10 | — | $13K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 TPA & PHARM BENEFIT MGR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Other fees; Claims processing; Direct payment from the plan; Other services; Contract Administrator; Participant communication Service code 12 | — | $9K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 THIRD PARTY ADMINISTRATO | Float revenue; Other services Service code 49 | — | $0 |
This section shows how the plan is funded and what that means for risk.
Welfare charges, retention and retention rate (the carrier margin on this plan) are on Pro.
7 contacts
Phone and email for the actuary are on Pro.
11 filings · 2015 to 2025