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 |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 NONE | Contract Administrator; Claims processing Service code 12 | — | $578K |
| BLUE CROSS BLUE SHIELD OF ALABAMA EIN 63-0103830 NONE | Claims processing; Contract Administrator Service code 12 | — | $363K |
| UNITED BEHAVORIAL HEALTH EIN 94-2649097 NONE | Claims processing; Contract Administrator Service code 12 | — | $167K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator; Claims processing Service code 12 | — | $162K |
| WAGEWORKS, INC. EIN 94-3351864 NONE | Contract Administrator; Claims processing Service code 12 | — | $162K |
| HEALTHAMERICA OF PENNSYLVANIA, INC EIN 62-1411933 NONE | Contract Administrator; Claims processing Service code 12 | — | $144K |
| NORTHGATEARINSO, INC EIN 65-1205969 NONE | Contract Administrator; Claims processing Service code 12 | — | $124K |
| CAPITAL DISTRICT PHYSICIAN'S HEALTH EIN 14-1641028 NONE | Contract Administrator; Claims processing Service code 12 | — | $74K |
| MVP SELECT CARE, INC EIN 14-1704347 NONE | Claims processing; Contract Administrator Service code 12 | — | $27K |
| CERIDIAN BENEFIT SERVICES EIN 59-3424469 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $23K |
| COVENTRY HEALTH CARE OF KANSAS, INC EIN 48-0840330 NONE | Contract Administrator; Claims processing Service code 12 | — | $22K |
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 | 4,286 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,286 | 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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.