No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 NONE | Claims processing Service code 12 | — | $674K |
| EXPRESS SCRIPTS EIN 42-1425239 NONE | Claims processing Service code 12 | — | $251K |
| EMPYREAN EIN 20-3029813 NONE | Recordkeeping fees Service code 64 | — | $196K |
| CLASS ADP EIN 13-3036745 NONE | Recordkeeping fees Service code 64 | — | $36K |
| CSC CONSULTING EIN 04-2593545 NONE | Consulting (pension) Service code 17 | — | $28K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
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 | 6,333 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,333 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE OF CALIFORNIA | 12 | $189K |
| Vision(3 contracts, 3 carriers) | UNITEDHEALTHCARE OF CALIFORNIA | 12 | $189K |
| Prescription drug(3 contracts, 3 carriers) | UNITEDHEALTHCARE OF CALIFORNIA | 12 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12 | — |
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 rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.