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 pricingNo prospect flags tripped on this filing.
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 17 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 | 6,993 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,034 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 4 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 239 | $3.9M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 3,274 | $332K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 6,755 | $745K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 7,215 | $1.3M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 163 | $1.1M |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 3,621 | $4.7M |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 6,755 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,215 | - |
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.
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM EIN 84-0747736 CLAIMS PROCESSING | Claims processing Service code 12 | — | $1.1M |
| LUCENT HEALTH SOLUTIONS LLC EIN 39-1997579 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 5560 W. GRANDE MARKET DRIVE APPLETON, WI 54913 | $734K |
| VALENTINE INSURANCE SERVICES EIN 83-0923712 BROKER | Insurance agents and brokers Service code 22 | 825 VALLEYBROOK ROAD SUITE 101 MEMPHIS, TN 38119 | $479K |
| NARUS HEALTH INC. EIN 47-1929604 OTHER | Other fees Service code 99 | 424 CHURCH STREET SUITE 2300 NASHVILLE, TN 37219 | $433K |
| RBHI LLC EIN 82-2076730 OTHER | Other fees Service code 99 | — | $315K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 CLAIMS PROCESSING | Claims processing Service code 12 | — | $253K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 NONE | Other fees Service code 99 | — | $150K |
| TELADOC, INC. EIN 04-3705970 OTHER | Other fees Service code 99 | — | $72K |
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.
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11 filings · 2015 to 2025