Filings through .
History & trajectory Charts need 2 or more years. This plan has 5 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: Dedecker-Saxe Associates Inc. LifeLTDSTD | LifeLTDSTD | |
Vision | Vision | |
Broker: Arthur J Gallagher Risk Management Life | Life |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 5 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 | 22,512 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 22,512 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 15,167 | $2.2M |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 21,980 | $11.0M |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 10,463 | $3.9M |
| Long-term disability | FIRST UNUM LIFE INSURANCE | 21,544 | $5.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 21,980 | - |
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: First Unum Life Insurance Company | |
Carrier: First Unum Life Insurance | |
Carrier: First Unum Life Insurance Company | |
Carrier: Ace American Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $13.0M |
| CVS CAREMARK EIN 05-0340626 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 1 CVS DRIVE WOONSOCKET, RI 02895 | $1.7M |
| DELTA DENTAL OF NY EIN 11-1980218 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 575 MADISON AVE NEW YORK, NY 10222 | $646K |
| FIRST UNUM LIFE INSURANCE COMPANY EIN 13-1898173 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $354K |
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.
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5 filings · 2021 to 2025