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 Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Broker: Img LifeOther | LifeOther | |
Dental | Dental | |
OtherHealthRx | OtherHealthRx | |
LTDOther | LTDOther | |
Vision | Vision | |
Health | Health | |
Other | Other |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 8 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 | 7,028 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 206 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,234 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICES ASSOCIATION | 45 | $415K |
| Dental | DELTA DENTAL OF OHIO | 13,342 | $5.2M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 11,273 | $931K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,259 | $5.3M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 7,028 | $1.5M |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 45 | $96K |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,259 | $8.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,342 | - |
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: Prudential Insurance Company of America |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Claims processing; Other services; Contract Administrator Service code 12 | — | $5.5M |
| VITALITY EIN 82-2597547 NONE | Other services Service code 49 | — | $1.1M |
| QUEST DIAGNOSTICS EIN 38-2084239 NONE | Other services Service code 49 | — | $409K |
| UNITED BEHAVIORAL HEALTH DBA OPTUM EIN 94-2649097 NONE | Contract Administrator; Claims processing Service code 12 | — | $300K |
| LIFE INSURANCE CO OF NORTH AMERICA EIN 23-1503749 NONE | Contract Administrator Service code 13 | — | $131K |
| OPTUMHEALTH BANK EIN 47-0858534 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $119K |
| WILLIS TOWERS WATSON EIN 23-1159360 NONE | Consulting (general) Service code 16 | — | $83K |
| GALLAGHER EIN 13-3954297 NONE | Consulting (general) Service code 16 | — | $60K |
| AON CONSULTING EIN 22-2232264 NONE | Consulting (general) Service code 16 | — | $39K |
| WALGREENS EIN 36-1924025 NONE | Other services Service code 49 | — | $34K |
| CLARK,SCHAEFER,HACKETT & CO EIN 31-0800053 NONE | Accounting (including auditing) Service code 10 | — | $30K |
| MERCER EIN 13-2834414 NONE | Consulting (general) Service code 16 | — | $24K |
| AMERICAN HEART ASSOCIATION EIN 13-5613797 NONE | Direct payment from the plan Service code 50 | — | $15K |
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