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 |
|---|---|---|---|
| GEM GROUP, L.P. EIN 23-1139840 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $106K |
| THE SEGAL COMPANY EIN 23-1835864 NONE | Actuarial; Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 11 | — | $74K |
| STACEY BRAUN ASSOCIATES, INC.. EIN 13-2889432 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $28K |
| MORGAN STANLEY SMITH BARNEY, LLC EIN 26-4310632 NONE | Securities brokerage commissions and fees; Other investment fees and expenses; Investment advisory (plan); Investment management fees paid directly by plan; Account maintenance fees; Other commissions; Securities brokerage; Other services Service code 27 | — | $25K |
| SUSANIN, WIDMAN & BRENNAN, PC EIN 23-2265950 NONE | Legal; Direct payment from the plan Service code 29 | — | $19K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $17K |
| SAGE ADVISORY SERVICES LTD CO. EIN 74-2798841 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $12K |
| CARELLA, BYRNE, BAIN, GILFILLIN EIN 22-2045935 NONE | Legal; Direct payment from the plan Service code 29 | — | $8K |
| ASB CAPITAL MANAGEMENT LLC EIN 80-0618452 NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | — | $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 | 211 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 512 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 576 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 46 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,345 | 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."
No prospect flags tripped on this filing.