No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE CO. EIN 06-6033492 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $1.0M |
| UNITED TEAMSTER FUND EIN 13-5549593 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $564K |
| DJ O'GRADY CONSULTANT NONE | Direct payment from the plan; Other services Service code 49 | 3219 E. TREMONT AVENUE BRONX, NY 10461 | $187K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $132K |
| CARY KANE, PLLC EIN 88-1989795 LEGAL COUNSEL | Legal; Direct payment from the plan Service code 29 | — | $67K |
| UNITED HEALTHCARE INSURANCE CO. EIN 41-2014834 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $52K |
| FIRST ACTUARIAL CONSULTING, INC. EIN 26-3842522 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $36K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 23-2180279 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $30K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 11-3658445 NONE | Other investment fees and expenses; Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $10K |
| EAGLE CAPITAL MANAGEMENT EIN 22-3361201 NONE | Investment management; Soft dollars commissions Service code 28 | — | $6K |
| PRINCIPAL CUSTODY SOLUTIONS EIN 51-0099493 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $2K |
| OPTUM, RX INC. EIN 33-0441200 NONE | Claims processing; Other fees; Direct payment from the plan; Float revenue Service code 12 | — | $0 |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,555 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,555 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.