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 pricingBroker comp is under 1% of premium on a plan over $1M. The plan may have no broker or pay a flat fee. Consultants can pitch it.
The filing reports zero broker compensation on a plan over 100 participants. The plan likely buys direct or does not report its broker. Give it a call.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Dental | Dental | |
HealthHMO | HealthHMO | |
PPOHealth | PPOHealth |
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 | 5,537 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,537 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMBLEM HEALTH | 77 | $1.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 2,931 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,931 | - |
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.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Participant communication; Named fiduciary; Claims processing; Other services; Float revenue; Contract Administrator; Non-monetary compensation; Direct payment from the plan Service code 12 | — | $1.2M |
| CVS PHARMACY, INC EIN 05-0340626 NONE | Direct payment from the plan; Account maintenance fees Service code 50 | — | $1.0M |
| WELLINGTON TRUST COMPANY NA EIN 04-2755549 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $193K |
| NISA INVESTMENT ADVISORS EIN 48-1140940 NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $184K |
| MELLON INVESTMENTS EIN 25-1442864 NONE | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Investment management Service code 28 | — | $81K |
| COHNREZNICK LLP EIN 33-4144829 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $55K |
| WEX HEALTH INC EIN 06-1593514 NONE | Direct payment from the plan; Account maintenance fees Service code 50 | — | $50K |
| IVINS PHILLIPS & BARKER EIN 52-1229560 NONE | Legal; Other fees Service code 29 | — | $31K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 INVESTMENT ADVISOR | Shareholder servicing fees; Float revenue; Trustee (directed); Direct payment from the plan; Other fees Service code 25 | — | $29K |
| RFN, INC. NONE | Direct payment from the plan; Copying and duplicating Service code 36 | 44 DREXEL DRIVE BAY SHORE, NY 11706 | $24K |
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $12K |
| BUCK GLOBAL, LLC EIN 13-3964297 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $11K |
| ERNST AND YOUNG NONE | Direct payment from the plan; Other services Service code 49 | 200 PLAZA DRIVE SECAUCUS, NJ 07094 | $10K |
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.
4 contacts
Phone and email for the actuary are on Pro.
11 filings · 2015 to 2025