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 compensation exceeds 5% of premium. This is a small-plan minimum fee or a costly broker setup that a competing bid can beat.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Broker: Amwins Group Benefits LLC Health | Health | |
Broker: Amwins Group Benefits LLC Rx | Rx |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 2 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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 286 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 286 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY MEDICARE SUPPLEMENT | 46 | $162K |
| Prescription drug | BENISTAR INC. PRESCRIPTION DRUG PLAN | 46 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 46 | - |
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.
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WIPFLI LLP EIN 41-2899048 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $17K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Soft dollars commissions; Recordkeeping fees; Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $14K |
| BSWIFT NONE | Direct payment from the plan; Consulting (general) Service code 16 | 10 S. RIVERSIDE PLAZA CHICAGO, IL 60606 | $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.
7 contacts
Phone and email for the actuary are on Pro.
11 filings · 2015 to 2025