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 |
|---|---|---|---|
| THE WAGNER LAW GROUP EIN 04-3323315 NONE | Legal; Direct payment from the plan Service code 29 | 8677 VILLA LA JOLLA DRIVE 888 SAN DIEGO, CA 92037 | $47K |
| CW BREITSMAN ASSOCIATES, LLC EIN 20-0064784 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Plan Administrator Service code 14 | 401 LIBERTY AVENUE, STE. 1625 PITTSBURGH, PA 15222 | $37K |
| CBIZ INVESTMENT ADVISORY SERVICES FIDUCIARY INVEST. ADVISOR | Direct payment from the plan; Investment management Service code 28 | 6050 OAK TREE BLVD. STE. 500 INDEPENDENCE, OH 44131 | $19K |
| GROSSMAN YANAK & FORD LLP EIN 25-1638525 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 401 LIBERTY AVENUE, STE. 1800 PITTSBURGH, PA 15222 | $18K |
| ACRISURE MID-ATL. PART. INS. SERV. EIN 92-3652116 NONE | Actuarial; Direct payment from the plan Service code 11 | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | $18K |
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 | 577 | 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) | 577 | 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.