Form 5500 · Employee benefit plan · ENGLEWOOD, CO
PRIME JET
The filing calls this plan PRIME JET HEALTH AND WELFARE BENEFIT PLAN.
PRIME JET of ENGLEWOOD, CO is a 109-participant transportation and logistics employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is USI INSURANCE SERVICES LLC. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-2454295 · plan 501 · plan year 2023, filed May 23, 2024
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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.
Benefits declared on this filing
Also declared: death benefits.
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 3 insured contracts covering health, dental, vision, life and disability; the largest, with CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 113 people.
Reported premium across the insured contracts is $538,605, with $68,588 in disclosed broker commissions — about 13% 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.
USI INSURANCE SERVICES LLC is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
Two carriers split the book: CIGNA HEALTH AND LIFE INSURANCE COMPANY and HARTFORD LIFE AND ACCIDENT.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health | 113 | Jan 1, 2024 | $343,835 | $42,999 |
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 104 | Jan 1, 2024 | $123,864 | $18,580 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental, Vision | 97 | Jan 1, 2024 | $70,906 | $7,009 |
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.
Other plans filed by this employer
How this plan compares
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