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Form 5500 · Employee benefit plan · SAN ANTONIO, TX

OUR LADY OF THE LAKE UNIVERSITY

The filing calls this plan THE HEALTH PLAN.

OUR LADY OF THE LAKE UNIVERSITY of SAN ANTONIO, TX files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Coverage is written through SWISS RE-SWISS RE. The plan's most recent policy period ended in April.

Benefits broker of record
Not disclosed
Insurance carrier
Policy year ends
Aprilas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 74-1109631 · plan 506 · plan year 2025, filed Mar 6, 2026

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How this plan is funded

Self-funded as reported

The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.

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.

All participants at the start of the year
244
Active at start of year
244
Active at end of year
226
Disclosed commissions
$0
Typical renewal
May 1

Benefits declared on this filing

Healthnot declared on this filing
Dentaldeclared under plan 505
Visiondeclared under plan 505
Lifedeclared under plan 501
Disabilitydeclared under plan 502

Also declared: 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.

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

The filing discloses a single insured line, stop-loss, through SWISS RE-SWISS RE, covering 226 people.

The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The premium and commission here are for the stop-loss contract, not for medical premium.

Reported premium is $663,896; the filing discloses no broker commission on these contracts.

The most recent policy period ended in April, and the plan year ends September 30. Group contracts typically renew on that annual cycle.

No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
SWISS RE-SWISS REStop-loss226Apr 2, 2025$663,896$0

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
OUR LADY OF THE LAKE UNIVERSITY
EIN 74-1109631
UMR, INC.
Claims processing · EIN 39-1995276
$171,548
paid directly by the plan
WORTHAM SAN ANTONIO INC
BROKER · EIN 74-2686053
$40,468
paid directly by the plan
OPTUMRX, INC.
Claims processing · EIN 33-0441200
$1,319,286
paid directly by the plan

The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.

Other plans filed by this employer

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