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 |
|---|---|---|---|
| DONALD COLEMAN EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $114K |
| DARYL K. GALLANT EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $98K |
| SCOTT H. MCDONALD EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $87K |
| TIC INTERNATIONAL CORP. EIN 13-2600875 NONE | Participant communication; Direct payment from the plan; Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 10 | — | $83K |
| GREGORY D. TAYLOR EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $80K |
| JAMES D. RUBEL EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $71K |
| JEFFREY D. SMRZ EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $68K |
| ERIC W. FIEDLER EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| KIM L. DENNISON EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $64K |
| JAMES CHAPMAN III EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| GREGORY A. BLAIR EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| GORDON PICHAN EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $61K |
| ELLIOTT J. COOK EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $59K |
| DAVID A. KOENIG EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
| ROBERT R. DEATER EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $51K |
| TIM M. STEIN EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $42K |
| PAMELA GAFFNER EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $41K |
| APRIL CUMMINGS EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $38K |
| HRISAIS K. SKORNA EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $38K |
| JON M. ERICKSON EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $35K |
| SCOTT HAMILTON EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $34K |
| BENDA, GRACE, STULZ & COMPANY, P.C. EIN 38-2284921 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $17K |
| SEGALL, BRYANT & HAMILL EIN 41-1788385 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $17K |
| LEGGHIO & ISRAEL, P.C. EIN 38-1971448 NONE | Legal; Direct payment from the plan Service code 29 | — | $17K |
| PAYCHEX, INC. EIN 16-1124166 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $11K |
| LABORERS JOINT DELINQUENCY COMM. EIN 38-2286296 NONE | Other services; Direct payment from the plan Service code 49 | — | $10K |
| CHAD A. EMIG EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $9K |
| JOHN WAHOVIAK EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $9K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $5K |
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 | 7,716 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,716 | 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.