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: Lakeshore Benefit Group Insurance Stop-loss | Stop-loss | |
Dental | Dental | |
Broker: Lakeshore Benefit Group Insurance LifeOther | LifeOther |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 3 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 | 499 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 299 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 798 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTAL SERVICES ORGANIZATION, LLC | 403 | $358K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 795 | $38K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 592 | $582K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 795 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 795 | - |
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: Amalgamated Life Insurance Company | |
Carrier: Metropolitan Life Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| I.E. SHAFFER & CO. EIN 22-1750854 NONE | Contract Administrator; Direct payment from the plan Service code 13 | 830 BEAR TAVERN ROAD WEST TRENTON, NJ 08628 | $442K |
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 NONE | Accounting (including auditing); Direct payment from the plan; Contract Administrator Service code 10 | 3 PENN PLAZA EAST NEWARK, NJ 07105 | $341K |
| MSPC CERTIFIED PUBLIC ACCOUNTANTS EIN 22-2951202 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 340 NORTH AVENUE EAST CRANFORD, NJ 07016 | $63K |
| CAPITAL RX, INC. EIN 35-2612946 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | 228 PARK AVENUE SOUTH, SUITE 87234 NEW YORK, NY 10003 | $63K |
| EMPOWER ANNUITY INSURANCE COMPANY EIN 06-1050034 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $57K |
| O'BRIEN, BELLAND & BUSHINSKY LLC EIN 37-1467056 NONE | Legal; Direct payment from the plan Service code 29 | — | $36K |
| EXPRESS SCRIPTS NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | ONE EXPRESS WAY ST LOUIS, MO 63121 | $25K |
| FIRST ACTUARIAL CONSULTING INC. EIN 26-3842522 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $15K |
| LINDABURY, MCCORMICK, ESTABROOK EIN 22-1943351 NONE | Legal; Direct payment from the plan Service code 29 | — | $11K |
| WEAVER C. BARKSDALE EIN 62-1217255 NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $9K |
| PROGRESSIVE BENEFIT SOLUTIONS, LLC NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | 14 BUSINESS PARK DRIVE 8 BRANFORD, CT 06405 | $6K |
| MILLIMAN INC. EIN 91-0675641 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $6K |
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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10 filings · 2016 to 2025