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 pricingBroker comp is under 1% of premium on a plan over $1M. The plan may have no broker or pay a flat fee. Consultants can pitch it.
Premium per covered life exceeds 2x the peer median for this NAICS and size cohort. The plan has rich benefits or a bad rate.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
HMOVision | HMOVision | |
HealthRx | HealthRx | |
Broker: Segal Company Stop-loss | Stop-loss | |
LifeOther | LifeOther | |
Vision | Vision | |
DentalHMO | DentalHMO |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 8 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 | 4,097 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,112 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 2,241 | $23.3M |
| Dental | SAFEGUARD HEALTH PLANS, INC. | 553 | $122K |
| Vision(3 contracts, 2 carriers) | EYEMED VISION CARE | 4,652 | $336K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 4,021 | $677K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 2,241 | $23.3M |
| Stop-loss / reinsurancereinsurance | WELLPOINT STOP LOSS | 1,157 | $6.1M |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 4,021 | $677K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,372 | - |
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: Wellpoint Stop Loss |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH SERVICES & BENEFIT ADMINISTR EIN 94-3084365 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $984K |
| ANTHEM BLUE CROSS EIN 95-3760980 NONE | Direct payment from the plan; Other services; Claims processing Service code 12 | — | $413K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461412 NONE | Claims processing; Plan Administrator; Direct payment from the plan Service code 12 | — | $264K |
| THE SEGAL COMPANY, INC. EIN 94-1503999 NONE | Insurance brokerage commissions and fees; Consulting (general); Actuarial; Direct payment from the plan Service code 11 | — | $262K |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $159K |
| WEINBERG, ROGER & ROSENFELD EIN 94-2458080 NONE | Legal; Direct payment from the plan Service code 29 | — | $129K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 11-3658445 NONE | Direct payment from the plan; Investment advisory (plan); Investment management fees paid indirectly by plan Service code 27 | — | $95K |
| ROAD RUNNER PRINTMAIL, INC. NONE | Other services; Direct payment from the plan Service code 49 | 100 RYAN INDUSTRIAL CT SAN RAMON, CA 94583 | $18K |
| CVS PHARMACY, INC EIN 05-0340626 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $18K |
| EYEMED NONE | Direct payment from the plan; Claims processing Service code 12 | 8570 WEST SUNSET BLVD WEST HOLLYWOOD, CA 90069 | $17K |
| SEGAL SELECT INSURANCE SERVICES EIN 46-0619194 NONE | Insurance brokerage commissions and fees Service code 53 | — | $16K |
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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11 filings · 2015 to 2025