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 |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 N/A | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $529K |
| BENEFIT & RISK MANAGEMENT N/A | Insurance services; Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | 80 IRON POINT CIRCLE, SUITE 200 FOLSOM, CA 95630 | $303K |
| EDGEWOOD PARTNERS INS CENTER N/A | Direct payment from the plan; Consulting (general); Other services Service code 16 | 1390 WILLOW PASS ROAD CONCORD, CA 94520 | $248K |
| MOSS ADAMS LLP EIN 91-0189318 N/A | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $104K |
| TOTAL WELLNESS N/A | Other services; Direct payment from the plan Service code 49 | 9320 H COURT OMAHA, NE 68127 | $30K |
| OMADA | Other services; Direct payment from the plan Service code 49 | 500 SANSOME ST 200 SAN FRANCISCO, CA 94111 | $26K |
| KILPATRICK TOWNSEND & STOCKTON N/A | Legal; Direct payment from the plan Service code 29 | 1080 MARSH ROAD MENLO PARK, CA 94025 | $25K |
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 | 1,286 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,295 | 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.