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 | — | $113K |
| DARYL K. GALLANT EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $97K |
| SCOTT H. MCDONALD EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $86K |
| GREGORY TAYLOR EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| 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 |
| JEFFREY D. SMRZ EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $80K |
| JAMES D. CHAPMAN III EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| JAMES D. RUBEL EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| ELIOTT J. COOK EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
| GREGORY A. BLAIR EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| KIM L. DENNISON EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| TIM M. STEIN EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| DAVID A. KOENIG EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| TYRESE A. WEST EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
| DEREK INMAN EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| LUIS PEREZ EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $53K |
| ANTONIO CALZADA EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| DAVID P. MILLER EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $49K |
| CRAIG R. PALLAS EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $47K |
| CHAD A. EMIG EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $47K |
| APRIL M. CUMMINGS EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $40K |
| HRISAIS K. SKORNA EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $40K |
| STEPHANIE E. ETCHIE EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $38K |
| GORDON P. PICHAN EIN 23-7187036 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $37K |
| LEGGHIO & ISRAEL, P.C. EIN 38-1971448 NONE | Legal; Direct payment from the plan Service code 29 | — | $34K |
| THERESA R. FREDERICK EIN 23-7187036 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $32K |
| SEGAL, BRYANT & HAMILL EIN 41-1788385 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $23K |
| BENDA, GRACE, STULZ & COMPANY, P.C. EIN 38-2284921 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $18K |
| PAYCHEX, INC. EIN 16-1124166 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $17K |
| LABORERS JOINT DELINQUENCY COMM. EIN 38-2286296 NONE | Direct payment from the plan; Other services Service code 49 | — | $9K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment management; Investment management fees paid directly by plan 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 | 9,119 | 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) | 9,119 | 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.