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 |
|---|---|---|---|
| AETNA EIN 06-6033492 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $424K |
| TOWERS WATSON EIN 26-0676603 NONE | Direct payment from the plan; Participant communication Service code 38 | — | $108K |
| PRUDENTIAL TRUST COMPANY NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | 30 ED PREARE DR SCRANTON, PA 185071755 | $72K |
| HANCHULAK LAW OFFICES P.C. NONE | Legal; Direct payment from the plan Service code 29 | 604 S STATE ST CLARKS SUMMIT, PA 18411 | $43K |
| FLEISHMAN LAW FIRM NONE | Legal; Direct payment from the plan Service code 29 | 565 5TH AVE NEW YORK, NY 10017 | $40K |
| BOLT KEENLEY KIM LLP NONE | Legal; Direct payment from the plan Service code 29 | 1010 GRAYSON ST NO 3 BERKELEY, CA 94710 | $30K |
| FOSTER LAW FIRM NONE | Legal; Direct payment from the plan Service code 29 | 601 E MCBEE AVE NO. 104 GREENVILLE, SC 29601 | $30K |
| JPMORGAN EIN 13-4994650 NONE | Direct payment from the plan; Distribution (12b-1) fees; Float revenue; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $22K |
| CROWE HORWATH EIN 35-0921680 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $21K |
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 | 0 | 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) | 0 | 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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.