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 pricingThe 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 |
|---|---|---|
Broker: Bolton Partners Inc Life | Life |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 1 contract 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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,563 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,563 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 3,722 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,722 | - |
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: Metropolitan Life Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELFARE & PENSION ADMIN SERVICE EIN 91-1363171 NONE | Contract Administrator Service code 13 | — | $577K |
| CVS PHARMACY, INC. EIN 05-0340626 NONE | Claims processing Service code 12 | — | $508K |
| SEGALL BRYANT & HAMILL EIN 35-2679129 NONE | Investment management Service code 28 | — | $218K |
| BOLTON PARTNERS, INC. EIN 52-1231144 NONE | Consulting (general); Actuarial Service code 11 | — | $132K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Investment management fees paid directly by plan; Custodial (securities); Investment management fees paid indirectly by plan Service code 19 | — | $117K |
| DELTA DENTAL EIN 31-0685339 NONE | Claims processing Service code 12 | — | $93K |
| UMR INC EIN 39-1995276 NONE | Claims processing Service code 12 | — | $84K |
| WEX EIN 06-1593514 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $75K |
| RHUMBLINE EIN 04-3118582 NONE | Investment management Service code 28 | — | $65K |
| BOLTON PARTNERS INVESTMENT CONSULT EIN 52-1871508 NONE | Investment advisory (plan) Service code 27 | — | $57K |
| PRINCIPAL BANK EIN 42-1466678 NONE | Float revenue; Custodial (securities); Investment management fees paid indirectly by plan Service code 19 | — | $54K |
| CANCER NAVIGATOR EIN 83-4163919 NONE | Other services Service code 49 | — | $44K |
| FRANCIS MARTORANA EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $43K |
| O'DONOGHUE & O'DONOGHUE EIN 52-0120528 NONE | Legal Service code 29 | — | $43K |
| ROGER MCCLOW EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $41K |
| MICHAEL BAILEY EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $33K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $29K |
| BOND BROTHERS EIN 36-2433269 NONE | Copying and duplicating Service code 36 | — | $29K |
| BRIAN DALEY EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $28K |
| MICHAEL STEPHENSON EIN 36-7485085 TRUSTEE | Trustee (individual) Service code 20 | — | $27K |
| EYEMED EIN 86-0773195 NONE | Claims processing Service code 12 | — | $13K |
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
11 filings · 2015 to 2025