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 |
|---|---|---|---|
| EMPLOYEE 838 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $180K |
| EMPLOYEE 428 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $157K |
| EMPLOYEE 597 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $147K |
| EMPLOYEE 495 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| EMPLOYEE 250 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $121K |
| EMPLOYEE 222 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $106K |
| EMPLOYEE 380 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| EMPLOYEE 684 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| EMPLOYEE 870 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| EMPLOYEE 259 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $104K |
| EMPLOYEE 501 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $99K |
| EMPLOYEE 151 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $99K |
| EMPLOYEE 517 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $99K |
| EMPLOYEE 251 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| EMPLOYEE 548 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| EMPLOYEE 958 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| EMPLOYEE 333 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $93K |
| EMPLOYEE 100 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| EMPLOYEE 406 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $88K |
| MRS CONNIE'S FAMILY CHILD CARE LLC EIN 27-0443226 NONE | Direct payment from the plan; Other services Service code 49 | — | $86K |
| EMPLOYEE 55 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $85K |
| EMPLOYEE 549 EIN 23-7418594 EMPLOYEE | Direct payment from the plan Service code 50 | — | $84K |
| EMPLOYEE 78 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| EMPLOYEE 888 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| EMPLOYEE 895 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| EMPLOYEE 99 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| EMPLOYEE 25 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| EMPLOYEE 777 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $81K |
| EMPLOYEE 636 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| EMPLOYEE 811 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $78K |
| EMPLOYEE 516 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $78K |
| EMPLOYEE 637 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| EMPLOYEE 547 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
| EMPLOYEE 111 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| EMPLOYEE 976 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| EMPLOYEE 491 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| EMPLOYEE 710 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $71K |
| EMPLOYEE 106 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| EMPLOYEE 88 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $69K |
| EMPLOYEE 876 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $67K |
| EMPLOYEE 450 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $63K |
| EMPLOYEE 217 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| EMPLOYEE 555 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| EMPLOYEE 950 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $61K |
| EMPLOYEE 803 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $60K |
| EMPLOYEE 741 EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $60K |
| EMPLOYEE 999 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| EMPLOYEE 103 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| PT EMPLOYEE A EIN 23-7418594 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| EMPLOYEE 932 EIN 23-7418594 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $57K |
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 | 9,306 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 9,306 | 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.