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.
The 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 |
|---|---|---|
HealthRxHMO | HealthRxHMO | |
HealthDentalHMO | HealthDentalHMO | |
Stop-loss | Stop-loss | |
LifeOther | LifeOther | |
Dental | Dental |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 9 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 | 839 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 54 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 893 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,331 | $12.9M |
| Dental(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 897 | $3.6M |
| Life insurance(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 825 | $159K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 1,331 | $9.4M |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 239 | $604K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 825 | $168K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,331 | - |
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 |
|---|---|---|---|
| BENESYS ADMINISTRATORS EIN 38-2383171 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $481K |
| OPTUM RX EIN 33-0441200 NONE | Float revenue; Claims processing; Direct payment from the plan; Other fees Service code 12 | — | $198K |
| US BANK EIN 31-0841368 NONE | Direct payment from the plan; Investment management; Custodial (securities) Service code 19 | — | $114K |
| ANTHEM BLUE CROSS LIFE AND H.I. CO. EIN 95-4331852 NONE | Contract Administrator; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $63K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $62K |
| WOHLNER KAPLON CUTLER HALFORD ET AL EIN 83-2856417 NONE | Legal; Direct payment from the plan Service code 29 | — | $31K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $28K |
| MICHAEL SUROWITZ EIN 26-2336426 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $22K |
| VSP EIN 94-1632821 NONE | Other services Service code 49 | — | $15K |
| FIRST DENTAL HEALTH EIN 33-0655193 NONE | Direct payment from the plan; Other services Service code 49 | — | $8K |
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