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 |
|---|---|---|---|
| CAREFIRST EIN 52-1385894 NONE | Claims processing Service code 12 | — | $1.6M |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Plan Administrator Service code 14 | — | $690K |
| WAGEWORKS EIN 94-3351864 NONE | Claims processing Service code 12 | — | $285K |
| SAGE ADVISORY SERVICE LTD. EIN 74-2798841 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $143K |
| DELTA DENTAL EIN 52-1479587 NONE | Plan Administrator; Claims processing Service code 12 | — | $113K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 NONE | Custodial (securities) Service code 19 | — | $109K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial; Consulting (general) Service code 11 | — | $92K |
| WELLS FARGO ADVISORS EIN 34-1542819 NONE | Investment advisory (plan) Service code 27 | — | $48K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $40K |
| DOYLE PRINTING & OFFSET CO. NONE | Copying and duplicating Service code 36 | 5206 46TH AVE HYATTSVILLE, MD 20781 | $12K |
| O'DONOGHUE & O'DONOGHUE EIN 53-0120528 NONE | Legal Service code 29 | — | $6K |
| MOUNT VERNON PRINTING COMPANY EIN 76-0190827 NONE | Copying and duplicating Service code 36 | — | $5K |
| OPTUM RX, INC. EIN 33-0441200 NONE | Direct payment from the plan; Float revenue; Claims processing; Other fees Service code 12 | — | $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 | 3,201 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 233 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,434 | 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.