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 |
|---|---|---|---|
| AON EIN 22-2232264 NONE | Actuarial; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Consulting (general) Service code 11 | — | $340K |
| B BELL/P ROZELLE NFL PLAYER RET PL EIN 13-6043636 NONE | Other services; Direct payment from the plan Service code 49 | — | $248K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Non-monetary compensation; Contract Administrator; Direct payment from the plan; Participant communication; Claims processing; Float revenue; Named fiduciary; Other services Service code 12 | — | $235K |
| GROOM LAW GROUP EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $223K |
| PNC CAPITAL ADVISORS, LLC EIN 22-1146430 NONE | Investment advisory (plan); Investment management fees paid directly by plan; Investment management Service code 27 | — | $179K |
| PCA, LLC EIN 26-2502340 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $36K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Direct payment from the plan; Float revenue; Shareholder servicing fees; Custodial (securities) Service code 19 | — | $31K |
| ABRAMS FOSTER NOLE & WILLIAMS, P.A EIN 52-1854049 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $26K |
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 | 1,732 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,329 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1,586 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,647 | 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.