See the carriers, broker commissions and premiums for this plan.
It also shows filing history and funding margin. Your first month is $4.99.
See 4 contract rows with premium, retention and renewal dates. $4.99 for your first month.
Solo adds 10-year history, peer benchmarks, provider and welfare analytics, saves, and exports. Then $34.99 a month.
See commissions and fees for 4 broker rows. $4.99 for your first month.
Solo adds 10-year history, peer benchmarks, provider and welfare analytics, saves, and exports. Then $34.99 a month.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FILICE INSURANCE AGENCY EIN 77-0261203 INSURANCE AGENT | Custodial (securities) Service code 19 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | $22K |
| CYPRESS BENEFIT ADMINISTRATORS, LLC EIN 39-1997579 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 5560 WEST GRANDE MARKET DRIVE APPLETON, WI 54913 | $22K |
| CONNECTICUT GENERAL EIN 06-0303370 OTHER | Other fees Service code 99 | 900 COTTAGE GROVE ROAD HARTFORD, CT 06152 | $11K |
| COKERWAYNE ASSOCIATES EIN 47-1082525 INSURANCE AGENT | Custodial (securities) Service code 19 | 355 BRYANT STREET, SUITE 206 SAN FRANCISCO, CA 94107 | $2K |
| ICR BRIDGE EIN 26-1513899 OTHER | Other fees Service code 99 | 818 WEST RIVERSIDE, SUITE 800 SPOKANE, WA 99201 | $826 |
| MBI BENEFITS EIN 38-3261866 OTHER | Other fees Service code 99 | ACCT DEPT BIN 129 MILWAUKEE, WV 53288 | $414 |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 94 | $450K |
| Vision | VISION SERVICE PLAN | 119 | $18K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 155 | $49K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 155 | $49K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 94 | $309K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 155 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 155 | — |
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."
Schedule A changed between filings. The plan moved between insured and self-funded, or contracts were added or removed. The transition window is open.