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 final-filing indicator is set. The plan is winding down. Skip it for sales.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 9 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. |
| Total participants (= "Plan participants" tile) | 0 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 4 carriers) | UPMC HEALTH PLAN | 0 | $594K |
| Dental(4 contracts, 3 carriers) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 0 | $214K |
| Vision(5 contracts, 4 carriers) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 0 | $318K |
| Prescription drug(6 contracts, 4 carriers) | UPMC HEALTH PLAN | 0 | $543K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 0 | $891K |
| Other(2 contracts) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 0 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | - |
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: Upmc Health Plan | |
Carrier: Cigna Health & Life Insurance Company | |
Carrier: Vision Service Plan | |
Carrier: Kaiser Foundation Health Plan of the Mid-Atlantic |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $598K |
| CBIZ BENEFITS & INSURANCE SERVICES EIN 31-1582098 ADMIN SUPPORT SERVICES | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 14 | 175 S MAIN STREET SUITE 720 SALT LAKE CITY, UT 84111 | $162K |
| UPMC BENEFIT MANAGEMENT SERVICES EIN 25-1769564 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 600 GRANT STREET PITTSBURGH, PA 15219 | $106K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSING | Participant communication; Named fiduciary; Contract Administrator; Float revenue; Non-monetary compensation; Claims processing; Direct payment from the plan; Other services Service code 12 | 111 S CALVERT ST SUITE 1600 BALTIMORE, MD 21202 | $52K |
| FRYE & COMPANY, CPAS EIN 45-4199441 PLAN AUDITOR | Accounting (including auditing) Service code 10 | 9161 LIBERIA AVENUE SUITE 304 MANASSAS, VA 20110 | $34K |
| AETNA BEHAVIORAL HEALTH, LLC EIN 06-6033492 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $19K |
| HEATLH & HUMAN RESOURCES CENTER INC EIN 33-0052273 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $0 |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CLAIMS PROCESSING | Contract Administrator Service code 13 | 501 US HIGHWAY 22 2ND FLOOR-WEST BRIDGEWATER, NJ 08807 | $0 |
| UPMC BENEFIT MANAGEMENT EIN 25-1769564 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 600 GRANT STREET PITTSBURGH, PA 15219 | $0 |
| VISION SERVICE PLAN EIN 23-7089668 CLAIMS PROCESSING | Claims processing; Non-monetary compensation; Float revenue; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator; Other services Service code 12 | 3333 QUALITY DR RANCHO CORDOVA, CA 95670 | $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.
2 contacts
10 filings · 2015 to 2024