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 COMPANY EIN 06-6033492 AFFIL. OF PARTY IN INT. | Contract Administrator Service code 13 | — | $10.1M |
| XEROX HR SOLUTIONS EIN 16-0468020 AFFIL. OF PARTY IN INT. | Plan Administrator Service code 14 | — | $1.7M |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 AFFIL. OF PARTY IN INT. | Non-monetary compensation; Direct payment from the plan; Contract Administrator; Other services; Participant communication; Named fiduciary; Claims processing; Float revenue Service code 12 | — | $1.3M |
| EXPRESS SCRIPTS EIN 43-1420563 AFFIL. OF PARTY IN INT. | Contract Administrator Service code 13 | — | $703K |
| RR DONNELLEY INC. EIN 42-4027878 NONE | Copying and duplicating Service code 36 | — | $609K |
| MAGELLAN HEALTHCARE INC EIN 52-2135463 AFFIL. OF PARTY IN INT. | Contract Administrator Service code 13 | — | $367K |
| PRICEWATERHOUSECOOPERS EIN 13-4008324 IND AUDITOR OF PLAN SPON | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $198K |
| MULTIPLAN, INC EIN 13-3068979 NONE | Contract Administrator Service code 13 | — | $197K |
| BNY MELLON NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | 225 LIBERTY STREET NEW YORK, NY 10286 | $112K |
| UNITED PARCEL SERVICES EIN 95-1732075 NONE | Other services Service code 49 | — | $112K |
| COTIVITI HEALTHCARE EIN 46-0634974 NONE | Contract Administrator Service code 13 | — | $87K |
| RAWLINGS COMPANY EIN 31-1563156 NONE | Contract Administrator Service code 13 | — | $42K |
| MULTIPLAN, INC. EIN 95-3778850 NONE | Contract Administrator Service code 13 | — | $35K |
| CORVEL CORPORATION EIN 95-3382819 NONE | Contract Administrator Service code 13 | — | $31K |
| TNS CUSTOM RESEARCH, INC. NONE | Other services Service code 49 | 2700 OREGON ROAD NORTHWOOD, OH 43619 | $22K |
| CERIDIAN BENEFIT SERVICES NONE | Other services Service code 49 | 3201 34TH STREET SOUTH ST. PETERSBURG, FL 33711 | $18K |
| OMNICLAIM EIN 27-0062838 NONE | Contract Administrator Service code 13 | — | $13K |
| CONEXIS WAGE WORKS NONE | Other services Service code 49 | PO BOX 8363 PASADENA, CA 91109 | $7K |
| SERVICE PRESS EIN 04-5709930 NONE | Contract Administrator Service code 13 | — | $7K |
| BUCK CONSULTANTS NONE | Other services; Actuarial; Other fees Service code 11 | 500 PLAZA DRIVE SECAUCUS, NJ 07094 | $7K |
| OPTUMINSIGHT EIN 41-1858498 NONE | Contract Administrator Service code 13 | — | $5K |
| CONTACT SOLULTIONS INC. | Other services Service code 49 | — | $4K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 43,933 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 43,933 | 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.