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 |
|---|---|---|---|
| PRINCIPAL FINANCIAL EIN 42-0127290 RECORDKEEPER/BOOKKEEPER | Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $54K |
| STOUT RISIUS ROSS, INC EIN 38-3003685 VALUATION SERVICES | Other fees; Valuation (appraisals, etc.) Service code 34 | — | $39K |
| ASSURED PARTNERS OF NORTH CAROLINA EIN 45-2712335 INSURANCE REP/BROKER | Insurance agents and brokers; Other fees Service code 22 | — | $13K |
| WITHUM SMITH & BROWN EIN 22-2027092 ACCOUNTANT | Other fees; Accounting (including auditing) Service code 10 | — | $10K |
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 | 208 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 248 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 253 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 11 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 720 | 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.