Form 5500 · Employee benefit plan · TULLAHOMA, TN
AMENTUM TECHNOLOGY, INC.
The filing calls this plan EMPLOYEE GROUP INSURANCE PLAN - FULLY INSURED COMPONENTS.
AMENTUM TECHNOLOGY, INC. of TULLAHOMA, TN is a 1,089-participant professional services employer — a large group whose insured benefits are disclosed on Schedule A of its Form 5500. Its broker of record is DIGITAL INSURANCE INC.. Coverage is written through BLUE CROSS AND BLUE SHIELD OF ALABAMA and 20 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 62-0510412 · plan 501 · plan year 2024, filed Oct 14, 2025
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1,160 other employer plans in Tennessee have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Also declared: prepaid legal, death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 38 insured contracts covering health, dental, vision, life, disability and stop-loss; the largest, with BLUE CROSS AND BLUE SHIELD OF ALABAMA, covers 770 people.
The filing lists a stop-loss contract. On its own that does not settle whether the plan pays its own claims.
Reported premium across the insured contracts is $12,261,564, with $357,716 in disclosed broker commissions — about 2.9% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
DIGITAL INSURANCE INC. is the broker of record on 14 of the 38 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| STANDARD INSURANCE COMPANY | Disability | 1,247 | Jan 1, 2025 | $896,551 | $134,483 |
| CONTINENTAL AMERICAN INSURANCE COMPANY | — | 462 | Jan 1, 2025 | $343,654 | $91,422 |
| STANDARD INSURANCE COMPANY | Disability | 1,227 | Jan 1, 2025 | $360,176 | $54,026 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 15,619 | Jan 1, 2025 | $1,741,269 | $17,413 |
| STANDARD INSURANCE COMPANY | Disability | 122 | Jan 1, 2025 | $65,721 | $9,858 |
| STANDARD INSURANCE COMPANY | Disability | 113 | Jan 1, 2025 | $63,352 | $9,503 |
| STANDARD INSURANCE COMPANY | Disability | 85 | Jan 1, 2025 | $54,554 | $8,183 |
| AFLAC | — | 164 | Jan 1, 2025 | $61,161 | $6,359 |
| STANDARD INSURANCE COMPANY | Disability | 121 | Jan 1, 2025 | $32,925 | $4,939 |
| HARTFORD LIFE AND ACCIDENT | — | 387 | Jan 1, 2025 | $143,971 | $4,339 |
| STANDARD INSURANCE COMPANY | Disability | 75 | Jan 1, 2025 | $19,419 | $2,913 |
| STANDARD INSURANCE COMPANY | Disability | 48 | Jan 1, 2025 | $19,131 | $2,870 |
| STANDARD INSURANCE COMPANY | Disability | 85 | Jan 1, 2025 | $16,483 | $2,472 |
| STANDARD INSURANCE COMPANY | Life | 143 | Jan 1, 2025 | $23,080 | $2,320 |
| STANDARD INSURANCE COMPANY | Disability | 142 | Jan 1, 2025 | $23,190 | $2,319 |
| BOSTON MUTUAL LIFE INSURANCE COMPANY | Life | 137 | Jan 1, 2025 | $27,420 | $1,347 |
| STANDARD INSURANCE COMPANY | Disability | 49 | Jan 1, 2025 | $7,420 | $1,113 |
| STANDARD INSURANCE COMPANY | Life | 84 | Jan 1, 2025 | $7,308 | $1,106 |
| STANDARD INSURANCE COMPANY | Disability | 24 | Jan 1, 2025 | $5,380 | $538 |
| BOSTON MUTUAL LIFE INSURANCE COMPANY | Life | 39 | Jan 1, 2025 | $7,266 | $367 |
| BLUE CROSS AND BLUE SHIELD OF ALABAMA | Health | 770 | Jan 1, 2025 | $2,515,903 | $0 |
| BLUE CROSS AND BLUE SHIELD OF ALABAMA | Health | 609 | Jan 1, 2025 | $1,581,500 | $0 |
| BLUE CARE NETWORK OF MICHIGAN | Health | 257 | Jan 1, 2025 | $1,295,770 | $0 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental | 137 | Jan 1, 2025 | $1,065,012 | $0 |
| VISION SERVICE PLAN | Vision | 6,744 | Jan 1, 2025 | $539,412 | $0 |
| KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | Health | 134 | Jan 1, 2025 | $248,007 | $0 |
| METROPOLITAN GENERAL INSURANCE COMPANY | — | 4,252 | Jan 1, 2025 | $226,282 | $0 |
| KAISER FOUNDATION HEALTH PLAN OF COLORADO | Health | 108 | Jan 1, 2025 | $209,210 | $0 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 63 | Jan 1, 2025 | $165,484 | $0 |
| UNITED BEHAVIORAL HEALTH DBA OPTUM | — | 16,311 | Jan 1, 2025 | $154,479 | $0 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 28 | Jan 1, 2025 | $40,336 | $0 |
| KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | Health | 6 | Jan 1, 2025 | $18,742 | $0 |
| KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. | Health | 6 | Jan 1, 2025 | $9,897 | $0 |
| HMSA | Health | 0 | Jan 1, 2025 | — | $0 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 0 | Jan 1, 2025 | — | $0 |
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | Health | 0 | Jan 1, 2025 | — | $0 |
| RELIASTAR LIFE INSURANCE COMPANY | Stop-loss | 18,308 | Jan 1, 2025 | — | $0 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 2,759 | Jan 1, 2025 | $272,099 | $-174 |
Premium and claims on these contracts
STANDARD INSURANCE COMPANY, contract 755089. For the contract year on this filing, the carrier reported $640,166 in premium earned and $195,470 in claims incurred. Dividing one by the other gives 31%.
STANDARD INSURANCE COMPANY, contract 755089. For the contract year on this filing, the carrier reported $257,528 in premium earned and $6,654 in claims incurred. Dividing one by the other gives 3%.
STANDARD INSURANCE COMPANY, contract 755088. For the contract year on this filing, the carrier reported $46,170 in premium earned and $38,931 in claims incurred. Dividing one by the other gives 84%.
STANDARD INSURANCE COMPANY, contract 755091. For the contract year on this filing, the carrier reported $44,744 in premium earned and $23,199 in claims incurred. Dividing one by the other gives 52%.
STANDARD INSURANCE COMPANY, contract 755090. For the contract year on this filing, the carrier reported $40,039 in premium earned and $13,508 in claims incurred. Dividing one by the other gives 34%.
STANDARD INSURANCE COMPANY, contract 755088. For the contract year on this filing, the carrier reported $23,060 in premium earned and $32,819 in claims incurred. Dividing one by the other gives 142%.
STANDARD INSURANCE COMPANY, contract 165460. For the contract year on this filing, the carrier reported $13,413 in premium earned and $-645 in claims incurred. Dividing one by the other gives -5%.
STANDARD INSURANCE COMPANY, contract 755090. For the contract year on this filing, the carrier reported $12,168 in premium earned and $814 in claims incurred. Dividing one by the other gives 7%.
STANDARD INSURANCE COMPANY, contract 759425. For the contract year on this filing, the carrier reported $16,159 in premium earned and $-261 in claims incurred. Dividing one by the other gives -2%.
STANDARD INSURANCE COMPANY, contract 759425. For the contract year on this filing, the carrier reported $16,348 in premium earned and $-352 in claims incurred. Dividing one by the other gives -2%.
STANDARD INSURANCE COMPANY, contract 755091. For the contract year on this filing, the carrier reported $5,295 in premium earned and $7,980 in claims incurred. Dividing one by the other gives 151%.
STANDARD INSURANCE COMPANY, contract 755091. For the contract year on this filing, the carrier reported $5,194 in premium earned and $-89 in claims incurred. Dividing one by the other gives -2%.
STANDARD INSURANCE COMPANY, contract 759425. For the contract year on this filing, the carrier reported $4,087 in premium earned and $364 in claims incurred. Dividing one by the other gives 9%.
BLUE CROSS AND BLUE SHIELD OF ALABAMA, contract 09817. For the contract year on this filing, the carrier reported $2,515,903 in premium earned and $3,151,777 in claims incurred. Dividing one by the other gives 125%.
BLUE CROSS AND BLUE SHIELD OF ALABAMA, contract 76201. For the contract year on this filing, the carrier reported $1,581,500 in premium earned and $1,464,506 in claims incurred. Dividing one by the other gives 93%.
BLUE CARE NETWORK OF MICHIGAN, contract 168396. For the contract year on this filing, the carrier reported $1,295,770 in premium earned and $1,155,846 in claims incurred. Dividing one by the other gives 89%.
- STANDARD INSURANCE COMPANY, contract 755089 reported $444,696 in retention.
- STANDARD INSURANCE COMPANY, contract 755089 reported $250,874 in retention.
- STANDARD INSURANCE COMPANY, contract 755088 reported $26,843 in retention.
- STANDARD INSURANCE COMPANY, contract 755091 reported $23,614 in retention.
- STANDARD INSURANCE COMPANY, contract 755090 reported $26,532 in retention.
- STANDARD INSURANCE COMPANY, contract 755088 reported $13,449 in retention.
- STANDARD INSURANCE COMPANY, contract 165460 reported $14,058 in retention.
- STANDARD INSURANCE COMPANY, contract 755090 reported $11,354 in retention.
- STANDARD INSURANCE COMPANY, contract 759425 reported $16,422 in retention.
- STANDARD INSURANCE COMPANY, contract 759425 reported $16,700 in retention.
- STANDARD INSURANCE COMPANY, contract 755091 reported $4,579 in retention.
- STANDARD INSURANCE COMPANY, contract 755091 reported $5,282 in retention.
- STANDARD INSURANCE COMPANY, contract 759425 reported $3,723 in retention.
- BLUE CROSS AND BLUE SHIELD OF ALABAMA, contract 09817 reported $222,657 in retention.
- BLUE CROSS AND BLUE SHIELD OF ALABAMA, contract 76201 reported $139,963 in retention.
- BLUE CARE NETWORK OF MICHIGAN, contract 168396 reported $269,765 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
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