Insurance carriers
8 carriers · 22 contracts · ranked by premium
#
Carrier
Coverage
Premium
Share
Covered
Retention
Renews
Primary broker
1
Filed as: HIGHMARK BLUE CROSS BLUE SHIELD
EIN 231294723 · Contract VARIOUS
$53.4M
77.1%
5,027
6.2%
-
2
EIN 941340523 · 2 contracts
$7.7M
11.1%
670
0.0%
-
2
Contract 102745-000
Filed as: KAISER FOUNDATION HEALTH PLAN OF CALIFORNIA-SOUTH
2021-01-01 → 2021-12-31
$7.6M
10.9%
670
0.0%
-
12
Contract 28998
Filed as: KAISER FOUNDATION HEALTH PLAN OF CALIFORNIA-NORTH
2021-01-01 → 2021-12-31
$146K
0.2%
13
0.0%
-
3
EIN 362114545 · 7 contracts
$3.9M
5.6%
13,279
0.0%
-
3
Contract 357706
2021-01-01 → 2021-12-31
$2.4M
3.5%
12,058
0.0%
-
5
Contract 358102
2021-01-01 → 2021-12-31
$930K
1.3%
3,643
0.0%
-
8
Contract 342132
2021-01-01 → 2021-12-31
$494K
0.7%
13,279
0.0%
-
16
Contract ETB 201322
2020-05-01 → 2021-04-30
$16K
0.0%
13,235
0.0%
-
19
Contract ETB 201141
2021-01-01 → 2021-12-31
$2K
0.0%
12
0.0%
-
20
Contract ETB 200939
2021-01-01 → 2021-12-31
$1K
0.0%
1,138
0.0%
-
21
Contract 00 VP 170001
2021-01-01 → 2021-12-31
$180
0.0%
61
0.0%
-
4
EIN 066033492 · 2 contracts
$2.2M
3.2%
4,690
0.0%
-
4
Contract VARIOUS
2021-01-01 → 2021-12-31
$1.9M
2.8%
4,690
0.0%
-
10
Contract DE6170
Filed as: AETNA INTERNATIONAL
2021-01-01 → 2021-12-31
$309K
0.4%
6
0.0%
-
5
EIN 135581829 · 4 contracts
$1.2M
1.7%
13,235
0.0%
-
7
Contract 0210808
2021-01-01 → 2021-12-31
$609K
0.9%
8,623
0.0%
-
9
Contract 6036796
2021-01-01 → 2021-12-31
$339K
0.5%
10,010
0.0%
-
11
Contract 0229100
2021-01-01 → 2021-12-31
$158K
0.2%
2,595
0.0%
-
14
Contract 0214387
2021-01-01 → 2021-12-31
$96K
0.1%
13,235
0.0%
-
6
Filed as: TRIPLE S
EIN 660555677 · Contract 1-10460-001
$709K
1.0%
107
0.0%
-
7
Filed as: CIGNA PPO
EIN 231503749 · Contract 060303370
$107K
0.2%
-
0.0%
-
8
EIN 060838648 · 4 contracts
$52K
0.1%
13,235
0.0%
-
15
Contract 709497
Filed as: THE HARTFORD
2021-01-01 → 2021-12-31
$39K
0.1%
113
0.0%
-
17
Contract 297064
Filed as: THE HARTFORD
2021-01-01 → 2021-12-31
$7K
0.0%
34
0.0%
-
18
Contract 709497
Filed as: THE HARTFORD
2021-01-01 → 2021-12-31
$6K
0.0%
110
0.0%
-
22
Contract 697331
Filed as: THE HARTFORD
2021-01-01 → 2021-12-31
$0
0.0%
13,235
-
-
Brokers
No brokers reported on this filing.
Service providers (Schedule C)
No Schedule C service providers reported on this filing.
Coverage breadth
6 benefit types
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).
Health✓Dental✓Short-term disability✓Long-term disability✓Prescription drug✓Not declared:VisionLifeDeath benefitsSeveranceUnemploymentSupplementalOther
Population walkthrough
22 Sch A contracts
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
Form 5500 line 6 — sponsor-reported, single number per filing
| Active participants | 13,235 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 13,235 | Active + retired/separated + beneficiaries. No dependents. |
Schedule A — per-contract enrollment, one row per coverage line
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|
| Health (medical)(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 4,690 | $3.0M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 10,010 | $647K |
| Life insurance(3 contracts) | CONTINENTAL CASUALTY COMPANY | 13,235 | $17K |
| Short-term disability | CONTINENTAL CASUALTY COMPANY | 13,279 | $494K |
| Long-term disability | CONTINENTAL CASUALTY COMPANY | 12,058 | $2.4M |
| Prescription drug | TRIPLE S | 107 | $709K |
| Other(13 contracts, 3 carriers) | CONTINENTAL CASUALTY COMPANY | 13,279 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,279 | — |
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."