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 pricingBroker comp is under 1% of premium on a plan over $1M. The plan may have no broker or pay a flat fee. Consultants can pitch it.
The top carrier holds over 85% of premium. A rate increase from that carrier moves the whole plan.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Health | Health | |
Broker: Lakeshore Ben Grp Ins Brokerage LLC DentalIndemnity | DentalIndemnity | |
Broker: Lakeshore Ben Grp Ins Brokerage LLC LifeSTDOther | LifeSTDOther | |
Vision | Vision |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 4 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 | 73 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 84 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC | 147 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 133 | $65K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 147 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $21K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $21K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | - |
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: Cigna Health and Life Insurance Company and Affiliates (Cigna) | |
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 |
|---|---|---|---|
| ASSOCIATED ADMINISTRATORS EIN 65-1205077 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Participant communication; Valuation (appraisals, etc.); Claims processing Service code 10 | 911 RIDGEBROOK ROAD SPARKS, MD 21152 | $114K |
| MOONEY, GREEN, SAINDON, MURPHY & WE NONE | Legal Service code 29 | 1920 L ST NW STE 400 WASHINGTON, DC 20036 | $13K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | 7501 WISCONSIN AVENUE, SUITE 1200W BETHESDA, MD 20814 | $12K |
| THE PHILADELPHIA TRUST COMPANY NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 1760 MARKET STREET PHILADELPHIA, PA 19103 | $10K |
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.
1 contact
10 filings · 2016 to 2025