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 |
|---|---|---|---|
| WEB-TPA EIN 75-2611444 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $689K |
| THE SEGAL COMPANY EIN 13-1975125 ACTUARY | Actuarial; Direct payment from the plan; Consulting (general) Service code 11 | — | $304K |
| WELLINGTON TRUST CO EIN 04-2755549 NONE | Investment management fees paid directly by plan; Direct payment from the plan Service code 50 | — | $78K |
| BENEFIT ELECT NONE | Direct payment from the plan; Other services Service code 49 | 835 S.W. YATES DR., SUITE 202 BEND, OR 97702 | $77K |
| VISION SERVICE PLAN EIN 75-2348381 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $54K |
| BENECARD RX NONE | Other services; Direct payment from the plan Service code 49 | P.O. BOX 90369 LAKELAND, FL 33804 | $49K |
| WILLIS TOWERS WATSON EIN 53-0181291 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $41K |
| STATE STREET BANK EIN 04-1867445 TRUSTEE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $36K |
| BHMS EIN 75-2403190 NONE | Direct payment from the plan; Investment management fees paid directly by plan Service code 50 | — | $30K |
| DIVERSIFIED BENEFIT SERVICES EIN 39-1695622 NONE | Direct payment from the plan; Other services Service code 49 | — | $29K |
| BDO USA, P.C. EIN 13-5381590 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $27K |
| WEX HEALTH NONE | Direct payment from the plan; Contract Administrator Service code 13 | 5120 WOODWAY DRIVE SUITE 6001 HOUSTON, TX 77056 | $19K |
| HARTNETT REYES-JONES EIN 43-1205253 NONE | Legal; Direct payment from the plan Service code 29 | — | $14K |
| FINISHING AND MAILING CENTER NONE | Other services; Direct payment from the plan Service code 49 | 2151 W COMMERCE ST. DALLAS, TX 75212 | $11K |
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 | 4,351 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,913 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 8,264 | 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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.