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.
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 10 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 | 2,706 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 146 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,852 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,768 | $5.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 5,241 | $8.6M |
| Vision | VISION SERVICE PLAN | 2,427 | $295K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 5,241 | $8.6M |
| Short-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 5,241 | $8.8M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 5,241 | $8.6M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,241 | $8.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,241 | - |
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: Metropolitan Life Insurance Company | |
Carrier: Kaiser Foundation Health Plan Inc. | |
Carrier: Kaiser Foundation Health Plan, Inc. | |
Carrier: Federal Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing; Other services; Direct payment from the plan Service code 12 | — | $2.8M |
| ANTHEM BLUE CROSS LIFE & HEALTH EIN 95-4331852 NONE | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Direct payment from the plan; Other services; Contract Administrator Service code 12 | — | $2.3M |
| EXECUTIVE FINANCIAL BENE-FACTS INC NONE | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | 4601 WILSHIRE BLVD 200 LOS ANGELES, CA 90010 | $437K |
| HEALTHEQUITY EIN 52-2383166 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $45K |
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