Filings through .
The top carrier holds over 85% of premium. A rate increase from that carrier moves the whole plan.
Schedule A changed between filings. The plan moved between insured and self-funded, or contracts were added or removed. The plan is in a transition year.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Broker: Kistler Tiffany Benefits Gener DentalVisionLife | DentalVisionLife | |
Broker: World Insurance Associates LLC Dental | Dental | |
Broker: One Digital Premier Services LLC STD | STD |
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 | 305 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 305 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 305 | $230K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 305 | $215K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 305 | $215K |
| Short-term disability | METROPOLITAN INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | - |
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.
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRIADA HEALTH LLC EIN 82-5371810 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | 15814 CHAMPION FOREST DR SUITE 260 SPRING, TX 77379 | $51K |
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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