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 | Claims processing; Direct payment from the plan Service code 12 | — | $15.4M |
| CITIZENS RX, LLC EIN 27-2485135 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $4.5M |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $1.7M |
| UCS HOLDINGS, LLC EIN 81-5149270 NONE | Direct payment from the plan; Other services Service code 49 | — | $351K |
| VISION SERVICE PLAN EIN 20-0891619 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $223K |
| PAYDHEALTH, LLC EIN 84-2853707 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $200K |
| MACNELL ACCOUNTING & CONSULTING,LLP EIN 30-0510353 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $165K |
| BUCK GLOBAL, LLC EIN 83-1116912 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $124K |
| TEAM WELLNESS AT WORK EIN 81-4050818 NONE | Direct payment from the plan; Other services Service code 49 | — | $54K |
| NATIONAL INVESTMENT SVCS OF AMERICA EIN 84-3937993 NONE | Investment management; Direct payment from the plan Service code 28 | — | $46K |
| ZELIS CLAIMS INTEGRITY LLC EIN 86-1040704 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $37K |
| STRATEGIC CAPITAL INVEST. ADVISOR EIN 36-4268991 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $23K |
| BRIDGEWAY BENEFIT TECHNOLOGIES, LLC EIN 52-1796473 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $21K |
| JACOBS, BURNS, ORLOVE EIN 36-2425981 NONE | Legal; Direct payment from the plan Service code 29 | — | $17K |
| BLUE CROSS MEDICARE ADVANTAGE NONE | Direct payment from the plan; Claims processing Service code 12 | 300 E. RANDOLPH STREET CHICAGO, IL 60601 | $15K |
| BAKER & HOSTETLER LLP EIN 34-0082025 NONE | Legal; Direct payment from the plan Service code 29 | — | $15K |
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 | 1,025 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 268 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,293 | 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.