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 |
|---|---|---|---|
| SEI INVESTMENTS COMPANY EIN 23-1707341 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $459K |
| ADMINISTRATIVE SERVICE PROFESSIONAL EIN 20-4056745 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $130K |
| UBS REALTY INVESTORS LLC EIN 06-1452020 NONE | Investment management fees paid directly by plan Service code 51 | — | $125K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $92K |
| STEVENS & LEE P.C. EIN 23-1886296 NONE | Legal; Direct payment from the plan Service code 29 | — | $86K |
| WILLIG WILLIAMS & DAVIDSON EIN 23-2416488 NONE | Legal; Direct payment from the plan Service code 29 | — | $54K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $36K |
| SEI TRUST COMPANY EIN 06-1271230 NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | — | $11K |
| SEGAL SELECT INSURANCE SERVICES, IN EIN 46-0619194 NONE | Insurance brokerage commissions and fees Service code 53 | — | $6K |
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 | 675 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,036 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 606 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 358 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 2,675 | 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.