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 |
|---|---|---|
Stop-loss | Stop-loss | |
Broker: The Hilb Group of New England, LLC HealthLife | HealthLife |
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 | 345 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 354 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 324 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 324 | $15K |
| Stop-loss / reinsurancereinsurance | PARTNERRE AMERICA INSURANCE CO | 354 | $454K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 354 | - |
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: Reliance Standard Life Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 39-1400101 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $187K |
| BLUE CROSS BLUE SHIELD OF WISCONSIN EIN 39-0138065 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $111K |
| UNITED ACTUARIAL SERVICES, INC. NONE | Direct payment from the plan; Actuarial Service code 11 | 11590 NORTH MERIDIAN ST, STE 610 CARMEL, IN 460324529 | $65K |
| THE PREVIANT LAW FIRM, S.C. EIN 39-1211596 NONE | Legal; Direct payment from the plan Service code 29 | — | $38K |
| STRATEGIC CAPITAL INVESTMENT EIN 36-4268991 NONE | Investment advisory (plan); Consulting fees Service code 27 | — | $30K |
| SIKICH CPA LLC EIN 54-1172176 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $28K |
| US BANK N.A. EIN 86-0441303 NONE | Direct payment from the plan; Investment management; Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $23K |
| MEDEXPERT INTERRNATIONAL, INC. EIN 94-3360248 NONE | Other fees Service code 99 | PO BOX 7550 MENLO PARK, CA 94026 | $22K |
| AURORA EMPLOYER SOLUTIONS EIN 39-1442285 NONE | Other fees; Direct payment from the plan Service code 50 | — | $20K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $18K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $14K |
| WEX HEALTH, INC. EIN 06-1593514 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $9K |
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