Health Plan Visibility Study 6 of 6 · A normal plan for half the people
A Texas building-trades contractor, about 190 employees
Real companies from the public filings. Figures rounded and details removed so they can’t be traced. Exact rows on request.
Among the lowest cost per employee of 52 peers, about $3,000 against a median of $6,094. Not because the plan is cheap: about 80 people are covered on a plan with about 190 employees, and per person covered the cost (about $6,900) is ordinary. The filing history also shows a calendar that slipped.
Year by year, from the filings
| Plan year | Employees on plan | Covered lives | Medical premium | Per employee | Broker pay | % of premium | Carrier |
|---|---|---|---|---|---|---|---|
| 2024 | about 190 | about 80 | $550K | $3,000 | $30,000 | 4.8% | B |
| 2023 | about 170 | about 250* | $600K | $3,600 | $35,000 | 5.8% | A |
| 2022 | about 180 | about 220* | $500K | $2,700 | $30,000 | 5.6% | A |
| 2021 | about 150 | about 190* | $500K | $3,300 | $30,000 | 6.3% | A |
| 2020 | about 150 | about 190* | $500K | $3,300 | $30,000 | 6.1% | A |
| 2019 | about 160 | about 60 | $400K | $2,500 | $25,000 | 5.7% | A |
*For four of these years one contract bundled medical with dental, vision, life and disability, so those years’ lives and premium are not medical-only; the first and last years are. Carriers are shown as letters. 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
- At most 44% of the workforce is covered. About 80 covered lives, employees plus dependents, on a plan with about 190 employees. The record cannot say whether that is eligibility, the contribution or the waiting period.
- The carrier changed in the latest year after six years with the same carrier. The filing cannot show what the outgoing renewal would have been or why the move was made.
- The filing calendar slipped. Several years of returns reached the DOL together, well after they were due. Late Form 5500s can carry DOL penalties, which the Delinquent Filer program can reduce; whether that was used is a question for the file. Broker pay itself is modest: about $35,000 across all lines, 4.8% of medical premium.
What the public record cannot show
- Eligibility, waivers and contributions by tier.
- Claims from either carrier.
- Whether the employee-only tier is affordable under the ACA employer mandate at this size.
Three questions a CFO can ask the broker today
- How many employees are eligible, how many are enrolled, and what does the employee-only tier cost an employee each month?
- How were the late filings resolved, and who owns the filing calendar now?
- May we have the written compensation disclosure, every payee, in dollars?
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.
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