Filings through .
History & trajectory Charts need 2 or more years. This plan has 7 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingThe top carrier holds over 85% of premium. A rate increase from that carrier moves the whole plan.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Broker: Healthcare Management Admin Stop-loss | Stop-loss |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 1 contract 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 | 213 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 213 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 205 | $463K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | - |
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: Sun Life Assurance Company of Canada |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 10700 NORTHUP WAY #100 BELLEVUE, WA 98004 | $157K |
| GARY LAPIDUS GARY LAPIDUS | Insurance agents and brokers Service code 22 | PO BOX 547 WEIMAR, CA 95736 | $66K |
| PRIME THERAPEUTICS LLC EIN 46-3708039 PHARMACY BENEFIT MANAGER | Other fees; Claims processing; Direct payment from the plan Service code 12 | 2900 AMES CROSSING ROAD SUITE 200 EAGAN, MN 55121 | $18K |
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.
2 contacts
7 filings · 2019 to 2025