A Texas building-trades contractor, about 160 employees

Cost per employee is among the ten highest of 52 peers, and the reason is not the price of the plan. The group carries 1.8 covered lives per employee and has grown about 60% in two years. Per covered person, the price has been flat since 2023.

Year by year, from the filings

Three plan years on file. One short plan year is annualized here. Dollar figures are rounded, and headcounts are rounded to the nearest 10. Peer group: 52 Texas electrical, plumbing/HVAC and building-systems contractors with 75 to 300 employees on a fully insured medical plan, from the same DOL files. Medians: $6,094 premium per employee, broker pay 5.3% of medical premium, $29 per employee per month.

Three facts from the public record

1. Per employee, expensive; per person, ordinary. About $10,100 per employee against a peer median of $6,094, but about $5,700 per covered life, which is about what peers pay per employee.
2. One carrier and one broker in every filing on record. The group has grown by about 60 employees under the same contract number.
3. Broker pay is at the peer rate and has nearly doubled in dollars. 5.3% of premium is the median; on a plan that doubled, that is about $45,000 in 2022 and about $85,000 a year now. In 2022 a second agency was also paid about $20,000 on the contract.

What the public record cannot show

• 24 months of claims: whether the group’s own experience or the market is setting the rate.
• The rate action in the next renewal letter.
• Contributions by tier. With 1.8 lives per employee, the family tier is where most of the cost and most of the employee decisions live.

Three questions a CFO can ask the broker today

1. May we have the written compensation disclosure for the plan, every payee, in dollars, as the Consolidated Appropriations Act requires?
2. May we see 24 months of claims against premium? At about 280 covered lives the carrier can produce it.
3. What other carriers and funding structures were priced at the last renewal, and what did each one come back at?

None of these questions costs anything or changes anything. They put what the plan’s fiduciary is supposed to know on paper.

From the company’s Form 5500 and Schedule A filings with the U.S. Department of Labor, as published in the DOL’s public datasets. Real companies from the public filings. Figures rounded and details removed so they can’t be traced. Exact rows on request. Advisory analysis, not legal or tax advice.

All six studies · Next: Study 2, Flat population, rising price