Filings through .
| Carrier | Coverage | Premium, renewal |
|---|---|---|
Broker: Custom Benefit Programs HealthDentalIndemnityOther | HealthDentalIndemnityOther | Pro |
HealthRxHMO | HealthRxHMO | Pro |
Broker: Aon Consulting Inc. LifeSTDLTDOther | LifeSTDLTDOther | Pro |
Vision | Vision | Pro |
See premium, retention and renewal dates for 9 contracts 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 Schedule C service providers reported on this filing.
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 | 122 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 114 | $3.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 114 | $2.8M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 282 | $19K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 196 | $195K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 196 | $195K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 196 | $195K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 34 | $408K |
| Other(4 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 196 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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."
Broker comp is under 1% of premium on a plan over $1M. The plan may have no broker or pay a flat fee. Consultant sales target.
Schedule A changed between filings. The plan moved between insured and self-funded, or contracts were added or removed. The transition window is open.