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.
| Carrier | Coverage | Premium |
|---|---|---|
HMO | HMO | |
Broker: Gallagher Benefit Services Inc Vision | Vision | |
Other | Other | |
Broker: Multi Agent System Corp HealthHMO | HealthHMO |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 6 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 | 22,282 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10,883 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 33,165 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MAPFRE LIFE INSURANCE COMPANY OF PR | 15 | $232K |
| Vision | VISION SERVICE PLAN | 17,771 | $3.8M |
| Other | CARELON BEHAVIORAL HEALTH | 50,356 | $934K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 50,356 | - |
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: Vision Service Plan | |
Carrier: Mapfre Life Insurance Company of PR |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NAVITUS HEALTH SOLUTIONS LLC - ADMI EIN 04-3608530 NA | Claims processing; Direct payment from the plan Service code 12 | — | $5.1M |
| UNITED HEALTHCARE INSURANCE CO NA | Direct payment from the plan; Other services Service code 49 | 115 WEST WAUSAU AVE WAUSAU, WI 54401 | $3.0M |
| SWORD HEALTH, INC. NA | Direct payment from the plan; Other services Service code 49 | 169 MADISON AVE NEW YORK, NY 10016 | $1.8M |
| BITS IN GLASS US, INC. NA | Consulting (general); Direct payment from the plan Service code 16 | 633 17TH STREET SUITE 1405 DENVER, CO 80202 | $828K |
| RX SAVINGS SOLUTIONS EIN 26-3642434 NA | Other services; Direct payment from the plan Service code 49 | — | $811K |
| MCG HEALTH LLC EIN 33-1104821 NA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Claims processing Service code 12 | — | $664K |
| NAYYA HEALTH, INC. NA | Other services; Direct payment from the plan Service code 49 | 215 PARK AVE S FL 4 NEW YORK, NY 10003 | $497K |
| TIVITY HEALTH, INC. EIN 62-1216689 NA | Direct payment from the plan; Other services Service code 49 | — | $476K |
| DST HEALTH SOLUTIONS LLC EIN 23-2423802 NA | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $449K |
| VIRTA MEDICAL P.C. EIN 36-4841662 NA | Other services; Direct payment from the plan Service code 49 | — | $421K |
| CHANGE HEALTHCARE SOLUTIONS LLC EIN 45-3637794 NA | Other services; Direct payment from the plan Service code 49 | — | $418K |
| TALON HEALTH TECH EIN 47-1212355 NA | Other services; Direct payment from the plan Service code 49 | — | $388K |
| LIVONGO HEALTH, INC. EIN 26-3542036 NA | Direct payment from the plan; Other services Service code 49 | — | $383K |
| METLIFE EIN 13-5581829 NA | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $268K |
| ZIONS NA | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | ONE SOUTH MAIN 11TH FLOOR SALT LAKE CITY, UT 84133 | $196K |
| AMERICAN PARA PROFESSIONAL SYSTEMS, NA | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 2487 HICKSVILLE, NY 11802 | $192K |
| UTAH HEALTH INFORMATION NETWORK NA | Direct payment from the plan; Other services Service code 49 | 1226 E 6600 S SALT LAKE CITY, UT 84121 | $168K |
| GDIT NA | Other services; Direct payment from the plan Service code 49 | PO BOX 829968 PHILADELPHIA, PA 19182 | $151K |
| DELOITTE EIN 13-3891517 NA | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $150K |
| MILLIMAN NA | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 1301 FIFTH AVENUE SUITE 3800 SEATTLE, WA 98101 | $148K |
| OPTUMINSIGHT, INC EIN 41-1858498 NA | Other services; Direct payment from the plan Service code 49 | — | $138K |
| FAIR HEALTH, INC. EIN 90-0524293 NA | Direct payment from the plan; Other services Service code 49 | — | $105K |
| CLARITY SOFTWARE SOLUTIONS, INC. NA | Participant communication; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 1801 W OLYMPIC BLVD PASADENA, CA 91199 | $93K |
| CLINICAL REFERENCE LABORATORY NA | Direct payment from the plan; Employee (plan); Claims processing Service code 12 | PO BOX 802273 KANSAS CITY, MO 64180 | $60K |
| UPTODATE EIN 04-3310941 NA | Other services; Direct payment from the plan Service code 49 | — | $40K |
| INTERLINK HEALTH SERVICES, INC EIN 93-1164345 NA | Direct payment from the plan; Other services Service code 49 | — | $36K |
| ACADIAN ASSET MANAGEMENT LLC EIN 04-2929221 NA | Investment management fees paid directly by plan Service code 51 | — | $36K |
| MACROMIND MEDIA INC. NA | Other services; Direct payment from the plan Service code 49 | — | $31K |
| MDX EIN 99-0283091 NA | Direct payment from the plan; Other services Service code 49 | — | $30K |
| EAGLE CAPITAL MANAGEMENT EIN 22-3361201 NA | Soft dollars commissions; Investment management fees paid directly by plan Service code 51 | — | $29K |
| PSG CONSULTING LLC EIN 27-2345574 NA | Direct payment from the plan; Other services Service code 49 | — | $28K |
| TOWERS WATSON SOFTWARE LIMITED NA | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $27K |
| RJ HEALTH SYSTEMS EIN 01-0744806 NA | Other services; Direct payment from the plan Service code 49 | — | $26K |
| NUANCE INVESTMENTS LLC EIN 26-3649176 NA | Investment management fees paid directly by plan Service code 51 | — | $25K |
| SOVOS COMPLIANCE LLC NA | Other services; Direct payment from the plan Service code 49 | PO BOX 3896 CAROL STREAM, IL 60132 | $25K |
| OPTUM360 EIN 46-3328307 NA | Other services; Direct payment from the plan Service code 49 | — | $24K |
| LSV ASSET MANAGEMENT EIN 23-2772200 NA | Investment management fees paid directly by plan Service code 51 | — | $24K |
| HARTFORD LIFE AND ACCIDENT INSURANC EIN 87-0467790 NA | Claims processing; Direct payment from the plan Service code 12 | — | $24K |
| IPD ANALYTICS NA | Other services; Direct payment from the plan Service code 49 | 19950 W COUNTRY CLUB DR SUITE 700 AVENTURA, FL 33180 | $22K |
| KIRTON MCCONKIE EIN 87-0375296 NA | Legal; Direct payment from the plan Service code 29 | — | $20K |
| SIDLEY AUSTIN LLP EIN 36-4474078 NA | Legal; Direct payment from the plan Service code 29 | — | $19K |
| VIRTUS PARTNERS INC EIN 95-4191764 NA | Investment management fees paid directly by plan Service code 51 | — | $19K |
| NEWTON INVESTMENT MANAGEMENT EIN 86-1751460 NA | Investment management fees paid directly by plan Service code 51 | — | $18K |
| ZAZOVE ASSOCIATES LLC EIN 36-3984373 NA | Investment management fees paid directly by plan; Soft dollars commissions Service code 51 | — | $17K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NA | Investment management fees paid indirectly by plan; Custodial (securities); Trustee (directed); Other services; Investment management fees paid directly by plan Service code 19 | — | $17K |
| CLEARWATER ANALYTICS NA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | 777 WEST MAIN STREET STE 900 BOISE, ID 83702 | $14K |
| FUNDAPPS INC. NA | Investment management; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 276 5TH AVE NEW YORK, NY 10001 | $13K |
| FACTSET RESEARCH SYSTEMS INC NA | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | PO BOX 414756 BOSTON, MA 02241 | $12K |
| BNY MELLON EIN 13-5160382 NA | Custodial (securities); Direct payment from the plan Service code 19 | — | $12K |
| BLOOMBERG FINANCE LP NA | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 731 LEXINGTON AVE NEW YORK, NY 10022 | $11K |
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.
3 contacts
Phone and email for the actuary are on Pro.
11 filings · 2015 to 2025