Filings through .
History & trajectory Charts need 2 or more years. This plan has 3 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingThe filing reports zero broker compensation on a plan over 100 participants. The plan likely buys direct or does not report its broker. Give it a call.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Health | Health | |
Stop-lossOther | Stop-lossOther | |
Dental | Dental | |
Dental | Dental | |
Vision | Vision |
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 | 160 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 160 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS | 180 | $48K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL | 160 | $13K |
| Vision | VISION SERVICE PLAN | 180 | $3K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE | 100 | $20K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 161 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | - |
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.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE OTHER THAN CONTRACT | Contract Administrator Service code 13 | — | $32K |
| BALDWIN MOFFITT BEHM LLP EIN 46-4370753 NONE OTHER THAN CONTRACT | Accounting (including auditing) Service code 10 | — | $10K |
| WELLS FARGO BANK NONE OTHER THAN CONTRACT | Other fees Service code 99 | P O BOX 6995 PORTLAND, OR 97278 | $10K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 NONE OTHER THAN CONTRACT | Consulting (general) Service code 16 | — | $7K |
| HARMONY HEALTHCARE EIN 04-3290453 NONE OTHER THAN CONTRACT | Consulting (general); Claims processing Service code 12 | — | $6K |
| ELIXIR RX SOLUTIONS LLC NONE OTHER THAN CONTRACT | Claims processing Service code 12 | 7835 FREEDOM AVE NW NORTH CANTON, OH 44720 | $5K |
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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3 filings · 2023 to 2025