Filings through .
| Carrier | Coverage | Premium, renewal |
|---|---|---|
LifeSTDIndemnityOther | LifeSTDIndemnityOther | Pro |
See premium, retention and renewal dates for 1 contract with Pro.
Pro shows premium, covered lives, retention, contract numbers and the renewal date for each contract. Free for 7 days, no card. Then $49 a month. Cancel any time.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 MEDICAL | Employee (plan) Service code 30 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $79K |
| BENEFIT SOURCE, INC EIN 57-0556933 TPA | Contract Administrator Service code 13 | 304 RIDGELAND DR GREENVILLE, SC 296012960 | $51K |
| FIRST HEALTH OF THE CAROLINAS, INC. EIN 56-1936354 ADMINISTRATOR | Employee (plan) Service code 30 | 155 MEMORIAL DRIVE PINEHURST, NC 28374 | $21K |
| EYEMED VISION CARE, LLC EIN 31-1656473 BENEFIT CARRIER | Employee (plan) Service code 30 | 4000 LUXOTTICA PLACE MASON, OH 45040 | $17K |
| BH BENEFITS EIN 50-9768480 BROKER | Custodial (securities) Service code 19 | 10440 CENTRAL EXPRESSWAY SUITE 800 DALLAS, TX 75231 | $10K |
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).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PAN AMERICAN LIFE INSURANCE COMPANY | 129 | $217K |
| Short-term disability | PAN AMERICAN LIFE INSURANCE COMPANY | 129 | $217K |
| Other | PAN AMERICAN LIFE INSURANCE COMPANY | 129 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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."
The top carrier holds over 85% of premium. A rate increase from that carrier moves the whole plan.
The filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported. Worth a call.
Schedule A changed between filings. The plan moved between insured and self-funded, or contracts were added or removed. The transition window is open.