SAGEWELL HEALTHCARE BENEFITS TRUST

Benefits declared on this filing

Health: the largest of the 3 insured health contracts, with PRUDENTIAL INSURANCE COMPANY OF AMERICA, covers 885 of 445,930 participants (0.2%) on Schedule A.

Life: the largest of the 92 insured life contracts, with SUN LIFE ASSURANCE COMPANY OF CANADA, covers 41,848 of 445,930 participants (9.4%) on Schedule A.

Disability: the largest of the 112 insured disability contracts, with SUN LIFE ASSURANCE COMPANY OF CANADA, covers 41,848 of 445,930 participants (9.4%) on Schedule A.

27 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.

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.

Schedule A insurance contracts

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

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.

Money the plan held and paid out

Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H

These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.