No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HCSC - BLUE CROSS BLUE SHIELD OF TX EIN 36-1236610 NONE | Claims processing; Insurance services; Contract Administrator; Direct payment from the plan Service code 12 | — | $449K |
| ERNST & YOUNG LLP EIN 34-6565596 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $167K |
| TEXAS INSTRUMENTS INCORPORATED EIN 75-0289970 SPONSOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $156K |
| FIDELITY EIN 04-2507163 NONE | Recordkeeping fees; Direct payment from the plan Service code 50 | — | $135K |
| NORTHERN TRUST COMPANY EIN 36-1561860 TRUSTEE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $50K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 NONE | Insurance services; Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $46K |
| CAREMARK, LLC EIN 05-0340626 NONE | Direct payment from the plan; Claims processing; Insurance services; Contract Administrator Service code 12 | — | $41K |
| BLACKROCK INST. TRUST CO, N.A. EIN 94-3112180 NONE | Investment management fees paid directly by plan Service code 51 | — | $8K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7,245 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 24 | $174K |
| Dental | AETNA LIFE INSURANCE CO. | 99 | $23K |
| Other | AETNA LIFE INSURANCE CO. | 99 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 99 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.