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 |
|---|---|---|---|
| IBB LOCAL LODGE NO. 1 EIN 36-1264124 AFFILATED ORG. | Other services Service code 49 | — | $101K |
| G. POCZEKAJ EIN 23-7046358 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| GREAT LAKES ADVISORS LLC EIN 80-0292839 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $41K |
| BANSLEY & KIENER, L.L.P. EIN 36-2152389 NONE | Accounting (including auditing) Service code 10 | — | $25K |
| PAYCHEX INC NONE | Other fees Service code 99 | 230 W MONROE STE 1020 CHICAGO, IL 60606 | $25K |
| COMMON ARC EIN 36-3595141 NONE | Recordkeeping fees; Other services Service code 49 | — | $23K |
| HOGAN, MARREN, BABBO & ROSE EIN 36-3340582 NONE | Legal Service code 29 | — | $13K |
| R.L. TRAXLER & ASSOCIATES LLC EIN 82-1544891 NONE | Contract Administrator; Other services Service code 13 | — | $11K |
| J.F. ERICKSON & ASSOCIATES NONE | Contract Administrator; Other services Service code 13 | 3203 PACIFIC DRIVE NAPLES, FL 34119 | $11K |
| BANK OF LABOR EIN 48-0150325 NONE | Custodial (securities) Service code 19 | — | $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 | 441 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 441 | 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.