No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS EIN 43-1420563 AFFIL. OF PARTY IN INT. | Contract Administrator Service code 13 | — | $13.1M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 AFFIL. OF PARTY IN INT. | Contract Administrator Service code 13 | — | $3.6M |
| CONDUENT HR SERVICES AFFIL. OF PARTY IN INT. | Plan Administrator Service code 14 | 100 CAMPUS DRIVE #200 FLORHAM PARK, NJ 07932 | $982K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 AFFIL. OF PARTY IN INT. | Non-monetary compensation; Named fiduciary; Participant communication; Float revenue; Direct payment from the plan; Contract Administrator; Other services; Claims processing Service code 12 | — | $801K |
| MAGELLAN HEALTHCARE INC EIN 52-2135463 AFFIL. OF PARTY IN INT. | Contract Administrator Service code 13 | — | $304K |
| PRICEWATERHOUSECOOPERS EIN 13-4008324 IND AUDITOR OF PLAN SPON | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $206K |
| BNY MELLON NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | 240 GREENWICH STREET NEW YORK, NY 10286 | $128K |
| RAWLINGS COMPANY EIN 31-1563156 NONE | Contract Administrator Service code 13 | — | $87K |
| MULTIPLAN, INC. EIN 95-3778850 NONE | Contract Administrator Service code 13 | — | $52K |
| COTIVITI HEALTHCARE EIN 46-0634974 NONE | Contract Administrator Service code 13 | — | $46K |
| OPTUMINSIGHT EIN 45-4683454 NONE | Contract Administrator Service code 13 | — | $38K |
| OMNICLAIM EIN 27-0062838 NONE | Contract Administrator Service code 13 | — | $19K |
| ALLIED PRINTING SERVICES EIN 06-0642973 NONE | Contract Administrator Service code 13 | — | $15K |
| EQUICLAIM EIN 20-5591816 NONE | Contract Administrator Service code 13 | — | $13K |
| WILLIS TOWERS WATSON AFFIL. OF PARTY IN INT. | Other services; Actuarial; Other fees Service code 11 | SUITE 4300. 500 N. AKARD STREET DALLAS, TX 75201 | $10K |
| CONTACT SOLUTIONS EIN 23-2518693 NONE | Other services Service code 49 | — | $9K |
| SERVICE PRESS EIN 04-5709930 NONE | Contract Administrator Service code 13 | — | $6K |
| UNITED PARCEL SERVICES EIN 36-2407381 NONE | Other services Service code 49 | — | $3K |
| EQUIAN EIN 27-1471112 NONE | Contract Administrator Service code 13 | — | $2K |
| AMPLIFON USA, INC. EIN 85-0437037 NONE | Other services Service code 49 | — | $0 |
| BANK OF AMERICA (LOCKBOX) EIN 59-1031071 NONE | Other services Service code 49 | — | $0 |
| BLOOMINGTON HOSPITAL EIN 35-1720796 NONE | Other services Service code 49 | — | $0 |
| BLOOMINGTON HOSPITAL OF ORANGE COUN EIN 35-2090919 NONE | Other services Service code 49 | — | $0 |
| CITIBANK NA EIN 59-1031071 NONE | Other services Service code 49 | — | $0 |
| CITIBANK NA (CHLIC CORE DEPOSITS) EIN 59-1031071 NONE | Other services Service code 49 | — | $0 |
| CLARK MEMORIAL HOSPITAL EIN 35-0944638 NONE | Other services Service code 49 | — | $0 |
| DAVIESS COMMUNITY HOSPITAL EIN 35-6001322 NONE | Other services Service code 49 | — | $0 |
| DEUTSCHE BANK EIN 59-1031071 NONE | Other services Service code 49 | — | $0 |
| FITBIT 199 EIN 20-8920744 NONE | Other services Service code 49 | — | $0 |
| FRANCISCAN HEALTH LAFAYETTE EIN 35-2056396 NONE | Other services Service code 49 | — | $0 |
| FRANCISCAN HEALTHCARE RENSSELAER | Other services Service code 49 | — | $0 |
| FRANCISCAN HEALTHCARE RENSSELAER (J EIN 35-1404051 NONE | Other services Service code 49 | — | $0 |
| GIBSON GENERAL HOSPITAL EIN 35-0877575 NONE | Other services Service code 49 | — | $0 |
| GOOD SAMARITAN HOSPITAL EIN 35-6001532 NONE | Other services Service code 49 | — | $0 |
| GOSHEN GENERAL HOSPITAL EIN 35-6001540 NONE | Other services Service code 49 | — | $0 |
| GREENE COUNTY GENERAL HOSPITAL EIN 35-6001492 NONE | Other services Service code 49 | — | $0 |
| MARGARET MARY COMMUNITY HOSPITAL EIN 35-6067049 NONE | Other services Service code 49 | — | $0 |
| MEADOWS HOSPITAL EIN 35-1858510 NONE | Other services Service code 49 | — | $0 |
| MONROE HOSPITAL EIN 20-2069733 NONE | Other services Service code 49 | — | $0 |
| MULTIPLAN INC. EIN 13-3068979 NONE | Contract Administrator Service code 13 | — | $0 |
| OAKLAWN PSYCHIATRIC CENTER EIN 35-1070041 NONE | Other services Service code 49 | — | $0 |
| OMADA HEALTH, INC EIN 45-2355015 NONE | Other services Service code 49 | — | $0 |
| PULASKI MEMORIAL HOSPITAL EIN 35-1097674 NONE | Other services Service code 49 | — | $0 |
| ST. JOSEPH REGIONAL MEDICAL CENTER EIN 35-1142669 NONE | Other services Service code 49 | — | $0 |
| ST. MARY'S MEDICAL CENTER EIN 35-0869065 NONE | Other services Service code 49 | — | $0 |
| ST. MARY'S WARRICK HOSPITAL EIN 35-1343019 NONE | Other services Service code 49 | — | $0 |
| STARKE MEMORIAL HOSPITAL (PRINCIPAL EIN 62-1763056 NONE | Other services Service code 49 | — | $0 |
| WHITE COUNTY MEMORIAL HOSPITAL EIN 35-1140233 NONE | Other services Service code 49 | — | $0 |
| WOODLAWN HOSPITAL EIN 35-1171815 NONE | Other services Service code 49 | — | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 39,685 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 39,685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 44,636 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 44,636 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.