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 | — | $6.9M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 AFFIL. OF PARTY IN INT. | Contract Administrator Service code 13 | — | $4.4M |
| ALIGHT SOLUTIONS LLC EIN 82-1061233 AFFIL. OF PARTY IN INT. | Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $934K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 AFFIL. OF PARTY IN INT. | Float revenue; Claims processing; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Other services; Contract Administrator Service code 12 | — | $600K |
| PRICEWATERHOUSECOOPERS EIN 13-4008324 IND AUDITOR OF PLAN SPON | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $212K |
| COTIVITI HEALTHCARE EIN 46-0634974 NONE | Contract Administrator Service code 13 | — | $71K |
| RAWLINGS COMPANY EIN 31-1563156 NONE | Contract Administrator Service code 13 | — | $55K |
| CONDUENT HR SERVICES AFFIL. OF PARTY IN INT. | Plan Administrator Service code 14 | 100 CAMPUS DRIVE #200 FLORHAM PARK, NJ 07932 | $49K |
| OPTUMINSIGHT EIN 45-4683454 NONE | Contract Administrator Service code 13 | — | $34K |
| OMNICLAIM EIN 27-0062838 NONE | Contract Administrator Service code 13 | — | $22K |
| WILLIS TOWERS WATSON AFFIL. OF PARTY IN INT. | Actuarial; Other services; Other fees Service code 11 | SUITE 4300. 500 N. AKARD STREET DALLAS, TX 75201 | $11K |
| MULTIPLAN, INC. EIN 13-3068979 NONE | Contract Administrator Service code 13 | — | $9K |
| END-GAME STRATEGY EIN 52-2261588 NONE | Contract Administrator Service code 13 | — | $5K |
| EQUIAN EIN 27-1471112 NONE | Contract Administrator Service code 13 | — | $1K |
| AMERICAN SPECIALTY HEALTH INCORPORA EIN 33-0883241 NONE | Participant communication; Float revenue; Named fiduciary; Contract Administrator; Non-monetary compensation; Claims processing; Other services; Direct payment from the plan Service code 12 | — | $0 |
| AMPLIFON USA, INC. EIN 85-0437037 NONE | Non-monetary compensation; Float revenue; Participant communication; Direct payment from the plan; Named fiduciary; Claims processing; Contract Administrator; Other services Service code 12 | — | $0 |
| BANK OF AMERICA (LOCKBOX) EIN 59-1031071 NONE | Named fiduciary; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Other services; Direct payment from the plan; Participant communication Service code 12 | — | $0 |
| BLOOMINGTON HOSPITAL EIN 35-1720796 NONE | Other services; Named fiduciary; Direct payment from the plan; Contract Administrator; Claims processing; Non-monetary compensation; Float revenue; Participant communication Service code 12 | — | $0 |
| BLOOMINGTON HOSPITAL OF ORANGE COUN EIN 35-2090919 NONE | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Claims processing; Non-monetary compensation; Contract Administrator; Float revenue Service code 12 | — | $0 |
| CITIBANK NA EIN 59-1031071 NONE | Other services; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan; Named fiduciary; Contract Administrator; Float revenue Service code 12 | — | $0 |
| CITIBANK NA (OMNIBUS) EIN 59-1031071 NONE | Non-monetary compensation; Float revenue; Participant communication; Direct payment from the plan; Named fiduciary; Claims processing; Contract Administrator; Other services Service code 12 | — | $0 |
| CITIBANK NA OMNIBUS | Non-monetary compensation; Float revenue; Claims processing; Other services; Contract Administrator; Direct payment from the plan; Participant communication; Named fiduciary Service code 12 | — | $0 |
| CLARK MEMORIAL HOSPITAL EIN 35-0944638 NONE | Other services; Float revenue; Direct payment from the plan; Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation Service code 12 | — | $0 |
| DAVIESS COMMUNITY HOSPITAL EIN 35-6001322 NONE | Other services; Direct payment from the plan; Contract Administrator; Participant communication; Float revenue; Named fiduciary; Non-monetary compensation; Claims processing Service code 12 | — | $0 |
| DEACONESS GIBSON HOSPITAL EIN 35-0877575 NONE | Non-monetary compensation; Contract Administrator; Float revenue; Claims processing; Named fiduciary; Direct payment from the plan; Participant communication; Other services Service code 12 | — | $0 |
| DEUTSCHE BANK EIN 59-1031071 NONE | Named fiduciary; Other services; Claims processing; Direct payment from the plan; Non-monetary compensation; Participant communication; Float revenue; Contract Administrator Service code 12 | — | $0 |
| FITBIT 199 EIN 20-8920744 NONE | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $0 |
| FRANCISCAN HEALTH LAFAYETTE EIN 35-2056396 NONE | Non-monetary compensation; Float revenue; Claims processing; Other services; Contract Administrator; Direct payment from the plan; Participant communication; Named fiduciary Service code 12 | — | $0 |
| FRANCISCAN HEALTHCARE RENSSELAER (J EIN 35-1404051 NONE | Claims processing; Float revenue; Other services; Participant communication; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $0 |
| GOOD SAMARITAN HOSPITAL EIN 35-6001532 NONE | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $0 |
| GOSHEN GENERAL HOSPITAL EIN 35-6001540 NONE | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $0 |
| GREEN COUNTY GENERAL HOSPITAL EIN 35-6001492 NONE | Float revenue; Claims processing; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Other services; Contract Administrator Service code 12 | — | $0 |
| GREENE COUNTY GENERAL HOSPITAL | Non-monetary compensation; Other services; Float revenue; Participant communication; Contract Administrator; Direct payment from the plan; Named fiduciary; Claims processing Service code 12 | — | $0 |
| LCA-VISION INC. EIN 11-2882328 NONE | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Other services; Contract Administrator; Direct payment from the plan Service code 12 | — | $0 |
| MARGARET MARY COMMUNITY HOSPITAL EIN 35-6067049 NONE | Non-monetary compensation; Named fiduciary; Participant communication; Float revenue; Direct payment from the plan; Contract Administrator; Other services; Claims processing Service code 12 | — | $0 |
| MEADOWS HOSPITAL EIN 35-1858510 NONE | Contract Administrator; Direct payment from the plan; Other services; Participant communication; Non-monetary compensation; Claims processing; Named fiduciary; Float revenue Service code 12 | — | $0 |
| MONROE HOSPITAL EIN 20-2069733 NONE | Other services; Participant communication; Direct payment from the plan; Claims processing; Non-monetary compensation; Float revenue; Named fiduciary; Contract Administrator Service code 12 | — | $0 |
| OAKLAWN PSYCHIATRIC CENTER EIN 35-1070041 NONE | Named fiduciary; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Other services; Direct payment from the plan; Participant communication Service code 12 | — | $0 |
| OMADA HEALTH, INC EIN 45-2355015 NONE | Named fiduciary; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Other services; Direct payment from the plan; Participant communication Service code 12 | — | $0 |
| PULASKI MEMORIAL HOSPITAL EIN 35-1097674 NONE | Contract Administrator; Other services; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan Service code 12 | — | $0 |
| ST. JOSEPH REGIONAL MEDICAL CENTER EIN 35-1142669 NONE | Named fiduciary; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Other services; Direct payment from the plan; Participant communication Service code 12 | — | $0 |
| ST. MARY'S MEDICAL CENTER EIN 35-0869065 NONE | Claims processing; Contract Administrator; Direct payment from the plan; Participant communication; Float revenue; Other services; Non-monetary compensation; Named fiduciary Service code 12 | — | $0 |
| ST. MARY'S WARRICK HOSPITAL EIN 35-1343019 NONE | Other services; Float revenue; Direct payment from the plan; Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation Service code 12 | — | $0 |
| STARKE MEMORIAL HOSPITAL (PRINCIPAL EIN 62-1763056 NONE | Other services; Float revenue; Contract Administrator; Named fiduciary; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $0 |
| VISION SERVICE PLAN VSP EIN 06-1227840 NONE | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Named fiduciary; Participant communication; Non-monetary compensation Service code 12 | — | $0 |
| WHITE COUNTY MEMORIAL HOSPITAL EIN 35-1140233 NONE | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Named fiduciary; Other services; Direct payment from the plan Service code 12 | — | $0 |
| WOODLAWN HOSPITAL EIN 35-1171815 NONE | Other services; Float revenue; Direct payment from the plan; Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation 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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36,434 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 36,434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 43,019 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 43,019 | — |
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.