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 pricingTotal premium grew more than 20% over the prior year. The plan is a good candidate to re-shop its carriers.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 7 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 | 745 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 752 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 3 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 235 | $221K |
| Vision | HORIZON INSURANCE COMPANY | 748 | $80K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 381 | $36K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 52 | $20K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 52 | $20K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 763 | $384K |
| Other | HARTFORD LIFE AND ACCIDENT | 381 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 763 | - |
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: Hartford Life and Accident | |
Carrier: United of Omaha Life Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HORIZON HEALTHCARE SERVICES EIN 22-0999690 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $668K |
| I. E. SHAFFER & CO. EIN 22-1750854 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $299K |
| NOVAK FRANCELLA EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $45K |
| JOHN M. FOWLER LLC EIN 22-3789539 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $20K |
| KAREN LEGG EIN 22-3789539 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $20K |
| CLEARY JOSEM & TRIGIANI, LLP EIN 23-2657967 NONE | Legal; Direct payment from the plan Service code 29 | — | $19K |
| MILLIMAN EIN 91-0675641 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $8K |
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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11 filings · 2015 to 2025