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: Willis Towers Watson Southeast, Inc HMO | HMO |
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 | 1,364 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 346 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,710 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
This filing has no Schedule A insurance contracts. This is typical of fully self-funded plans. The only headcount is the Form 5500 number above.
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: Kaiser Foundation Health Plan of the Mid-Atlantic States,inc. |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $306K |
| MELLON CAPITAL MANAGEMENT EIN 24-1442864 TRUSTEE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution); Investment management fees paid directly by plan; Investment management Service code 21 | — | $230K |
| GROOM LAW GROUP, CHARTERED EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $181K |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 NONE | Contract Administrator Service code 13 | — | $109K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 TRUSTEE/CUSTODIAL | Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Investment management Service code 21 | — | $101K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 N/A | Plan Administrator Service code 14 | — | $81K |
| GRANT THORTON LLP EIN 36-6055558 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $50K |
| TOWERS WASTON INVESTMENT SERVICES EIN 52-1868818 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $19K |
| CALIBRE EIN 47-0900880 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $10K |
| ALIGHT EIN 36-2235791 RECORDKEEPER | Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $0 |
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.
6 contacts
Phone and email for the actuary are on Pro.
11 filings · 2015 to 2025