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 |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 36-1236610 NONE | Contract Administrator Service code 13 | — | $13.2M |
| CITIZENS RX, LLC EIN 27-2485135 NONE | Contract Administrator Service code 13 | — | $4.3M |
| DELTA DENTAL EIN 36-2612058 NONE | Contract Administrator Service code 13 | — | $1.5M |
| MACNELL ACCOUNTING&CONSULTING, LLP EIN 30-0510353 NONE | Accounting (including auditing) Service code 10 | — | $150K |
| JACOBS, BURNS, ORLOVE, STANTON EIN 36-2425981 NONE | Insurance agents and brokers Service code 22 | — | $41K |
| NATIONAL INVESTMENT SERVICES, INC. EIN 80-0169636 NONE | Consulting (pension) Service code 17 | — | $39K |
| TFBC, LLC EIN 27-3782504 NONE | Consulting (general) Service code 16 | — | $38K |
| HINES AND ASSOCIATES, INC. EIN 36-3545085 NONE | Other services Service code 49 | — | $31K |
| RIDER DICKERSON, INC. EIN 36-2329183 NONE | Other services Service code 49 | — | $28K |
| STRATEGIC CAPITAL INVEST. ADVISOR EIN 36-4268991 NONE | Consulting (pension) Service code 17 | — | $19K |
| EMPLOYEE RESOURCE SYSTEMS, INC EIN 36-3867645 NONE | Other services Service code 49 | — | $17K |
| ISSI EIN 23-2182079 NONE | Consulting (general) Service code 16 | — | $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 | 1,051 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 191 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,242 | 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.