Filings through .
| Carrier | Coverage | Premium, renewal |
|---|---|---|
Broker: Gallagher Benefit Services Inc. HealthRxPPO | HealthRxPPO | Pro |
Broker: Gallagher Benefit Services Inc. DentalVisionLifeSTDLTDPPO | DentalVisionLifeSTDLTDPPO | Pro |
See premium, retention and renewal dates for 2 contracts with Pro.
Pro shows premium, covered lives, retention, contract numbers and the renewal date for each contract. Free for 7 days, no card. Then $49 a month. Cancel any time.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC. EIN 41-1289245 | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $38K |
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).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 31 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 31 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 27 | $351K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 31 | $39K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 31 | $39K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 31 | $39K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 31 | $39K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 31 | $39K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 27 | $351K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 31 | — |
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."
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 transition window is open.