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.
Premium per covered life exceeds 2x the peer median for this NAICS and size cohort. The plan has rich benefits or a bad rate.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Dental | Dental | |
Broker: Centerstone Ins and Financial Stop-loss | Stop-loss | |
HealthRxHMO | HealthRxHMO | |
Health | Health |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 6 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 | 724 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 724 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC STATES, INC. | 30 | $363K |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 607 | $519K |
| Prescription drug(3 contracts) | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC STATES, INC. | 30 | $332K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 607 | $459K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 607 | - |
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: Symetra Life Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $342K |
| MERCER INVESTMENTS LLC EIN 30-0282430 NONE | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 51 | — | $168K |
| GALLAGHER EIN 13-3954297 NONE | Actuarial; Direct payment from the plan; Consulting (general) Service code 11 | — | $76K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $50K |
| VANGUARD EIN 23-2186884 NONE | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 51 | — | $49K |
| WOMBLE BOND DICKINSON (US) LLP EIN 56-0308470 NONE | Legal Service code 29 | — | $38K |
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.
5 contacts
Phone and email for the actuary are on Pro.
11 filings · 2015 to 2025