Insurance carriers
15 carriers · 36 contracts · ranked by premium
#
Carrier
Coverage
Premium
Share
Covered
Retention
Renews
Primary broker
1
EIN 362739571 · Contract H0755*
$2.3M
26.0%
566
0.0%
-
2
EIN 066033492 · 5 contracts
$2.0M
22.0%
764
0.2%
-
2
Contract AE466350
Filed as: AETNA LIFE INSURANCE CO.
2016-01-01 → 2016-12-31
$1.6M
18.6%
764
0.0%
-
15
Contract 6203790012
Filed as: COVENTRY HEALTH CARE OF MISSOURI
2016-01-01 → 2016-12-31
$127K
1.4%
40
0.0%
-
16
Contract AE466355
Filed as: AETNA LIFE INSURANCE CO.
2016-01-01 → 2016-12-31
$125K
1.4%
57
0.0%
-
23
Contract 0725120-0836411
Filed as: AETNA LIFE INSURANCE CO.
2016-01-01 → 2016-12-31
$48K
0.5%
3
6.2%
-
34
Contract 7000620000
Filed as: COVENTRY HEALTH CARE OF IOWA
2016-01-01 → 2016-12-31
$9K
0.1%
4
0.0%
-
3
EIN 391263473 · 5 contracts
$1.1M
12.6%
260
0.0%
-
3
Contract *SEE BELOW
2016-01-01 → 2016-12-31
$900K
10.1%
260
0.0%
-
19
Contract 259652 & 259702
Filed as: HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.
2016-01-01 → 2016-12-31
$108K
1.2%
33
0.0%
-
22
Contract 292405 & 292424
Filed as: HUMANA BENEFIT PLAN OF ILLINOIS, INC.
2016-01-01 → 2016-12-31
$49K
0.6%
10
0.0%
-
26
Contract *SEE BELOW
Filed as: HUMANA MEDICAL PLAN, INC.
2016-01-01 → 2016-12-31
$30K
0.3%
29
0.0%
-
27
Contract 76217
Filed as: HUMANA HEALTH PLAN. INC.
2016-01-01 → 2016-12-31
$29K
0.3%
8
0.0%
-
4
EIN 941340523 · 6 contracts
$1.1M
12.5%
132
0.0%
-
5
Contract 8777
Filed as: KAISER FOUNDATION HEALTH PLAN INC (CALIFORNIA)
2016-01-01 → 2016-12-31
$340K
3.8%
127
0.0%
-
6
Contract 106231
Filed as: KAISER FOUNDATION HEALTH PLAN INC (CALIFORNIA)
2016-01-01 → 2016-12-31
$316K
3.6%
132
0.0%
-
9
Contract 1562
Filed as: KAISER FOUNDATION HEALTH PLAN OF COLORADO
2016-01-01 → 2016-12-31
$189K
2.1%
65
0.0%
-
14
Contract 4106
Filed as: KAISER FOUNDATION HEALTH PLAN OF THE MID-ALTANTIC
2016-01-01 → 2016-12-31
$132K
1.5%
43
0.0%
-
20
Contract 150
Filed as: KAISER FOUNDATION HEALTH PLAN OF GEORGIA
2016-01-01 → 2016-12-31
$107K
1.2%
26
0.0%
-
28
Contract 996
Filed as: KAISER FOUNDATION HEALTH PLAN OF HAWAII
2016-01-01 → 2016-12-31
$25K
0.3%
6
0.0%
-
5
Filed as: EMBLEM HEALTH
EIN 131828429 · Contract 1009056000
$764K
8.6%
199
0.0%
-
6
EIN 952931460 · 8 contracts
$428K
4.8%
36
0.0%
-
11
Contract 144472
Filed as: UNITEDHEALTHCARE OF CALIFORNIA
2016-01-01 → 2016-12-31
$162K
1.8%
36
0.0%
-
12
Contract 092016
Filed as: UNITEDHEALTHCARE OF COLORADO
2016-01-01 → 2016-12-31
$152K
1.7%
35
0.0%
-
24
Contract 060469
Filed as: UNITEDHEALTHCARE OF ARIZONA
2016-01-01 → 2016-12-31
$42K
0.5%
12
0.0%
-
29
Contract 039984
Filed as: UNITEDHEALTHCARE OF OREGON, INC.
2016-01-01 → 2016-12-31
$23K
0.3%
5
0.0%
-
30
Contract 036562
Filed as: UNITEDHEALTHCARE BENEFITS OF TEXAS, INC.
2016-01-01 → 2016-12-31
$23K
0.3%
7
0.0%
-
33
Contract 804253
Filed as: UNITEDHEALTHCARE OF WASHINGTON, INC
2016-01-01 → 2016-12-31
$10K
0.1%
2
0.0%
-
35
Contract 667071
Filed as: UNITEDHEALTHCARE OF NEVADA
2016-01-01 → 2016-12-31
$8K
0.1%
2
0.0%
-
36
Contract 808280
Filed as: UNITEDHEALTHCARE OF OKLAHOMA, INC.
2016-01-01 → 2016-12-31
$7K
0.1%
1
0.0%
-
7
EIN 141640868 · 2 contracts
$342K
3.9%
55
0.0%
-
8
Contract 700911
2016-01-01 → 2016-12-31
$229K
2.6%
55
0.0%
-
18
Contract 10001827
Filed as: CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC.
2016-01-01 → 2016-12-31
$113K
1.3%
31
0.0%
-
8
EIN 954402957 · Contract SEE BELOW*
$280K
3.2%
56
0.0%
-
9
Filed as: TUFTS HEALTH PLAN MEDICARE PREFERRED
EIN 042674079 · Contract 1285
$170K
1.9%
50
0.0%
-
10
Filed as: TRIPLE S ADVANTAGE
EIN 660593034 · Contract 069
$150K
1.7%
93
0.0%
-
11
EIN 161483784 · Contract 14785N 01
$122K
1.4%
19
0.0%
-
12
Filed as: HEALTHPARTNERS
EIN 410797853 · Contract 60738
$64K
0.7%
16
0.0%
-
13
EIN 943037165 · Contract GR001312
$35K
0.4%
13
0.0%
-
14
Filed as: BLUE CROSS AND BLUE SHIELD
EIN 850327237 · Contract 20000900
$18K
0.2%
9
0.0%
-
15
Filed as: CIGNA HEALTHCARE OF ARIZONA, INC.
EIN 860334392 · Contract 4173
$18K
0.2%
17
0.0%
-
Brokers
No brokers reported on this filing.
Service providers (Schedule C)
No Schedule C service providers reported on this filing.
Coverage breadth
1 benefit type
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).
Health✓Not declared:DentalVisionLifeShort-term disabilityLong-term disabilityPrescription drugDeath benefitsSeveranceUnemploymentSupplementalOther
Population walkthrough
36 Sch A contracts
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
Form 5500 line 6 — sponsor-reported, single number per filing
| Active participants | 2 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11,632 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 11,645 | Active + retired/separated + beneficiaries. No dependents. |
Schedule A — per-contract enrollment, one row per coverage line
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|
| Health (medical)(34 contracts, 33 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 566 | $7.1M |
| Vision | HEALTH NET | 56 | $280K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 764 | — |
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."