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 |
|---|---|---|---|
| GUTIERREZ JR, MANUEL EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $162K |
| DATA DESIGN SYSTEMS EIN 27-3172883 | Other fees Service code 99 | — | $151K |
| SEMAN, ROBERT EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $145K |
| SINGLETON, JAMES D. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $129K |
| BROOKS, BENJAMIN P. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $127K |
| FUENTES, MATTHEW T. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $127K |
| GROVES, RICHARD E. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $127K |
| CAMECHIS, JAMES B. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $112K |
| ROCK, FALLON R. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $108K |
| DRAKE, BRANDON L. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $108K |
| HOLLAND, JOSHUA EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $108K |
| VAN FOSSEN, MICHAEL W. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $108K |
| RIGGI, JEFFREY S. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $107K |
| RUNK, MARK A. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $107K |
| MCNEMAR, ZACHARY EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $107K |
| BRAUNSTEIN, WILLIAM J. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| BUTCHER, BRENT C. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| COX, ERIC EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| DEARTH, TRENT R. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| DECK, JASON M. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| DRAUR, ELIZABETH EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| EWERSEN, ERIC EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| GEORGE, GABRIEL A EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| HALL, DECARLOS R. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| HARGRAVE JR., ROBERT E. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| HENDERSON, MICHAEL R. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| HOELTER, THOMAS G EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| IRWIN, EVAN A. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| JORDAN III, DAVID A. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| LISCOE JR, JOHN P EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| MATOUSEK, ERIC J. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| NUHFER, KENNETH A EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| SUGGS, CHRISTOPHER D. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $106K |
| STOCK, JOHN F. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $99K |
| BLACK, SHELBY N. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $81K |
| GODWIN, NICHOLAS EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $80K |
| EROSHEVICH, SASHA EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $78K |
| TUCKER, TERRI L. EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $77K |
| MEYER, ROBERT EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $72K |
| FINCH JR., TIMOTHY EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $71K |
| RONSKI, DAWN F EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $68K |
| MARTIN, CONNIE EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $67K |
| PHILLIPS, SHALENE D EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $65K |
| SEALS, JANAE R EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $64K |
| NORRIS, MARK A EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $59K |
| MAGAZINE, LAURA EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $57K |
| CINTAS EIN 31-1188630 | Other fees Service code 99 | — | $55K |
| FISK, EVAN EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $54K |
| TACKETT, MACKENZIE EIN 31-6057717 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $50K |
| TECHNIQUE ROOFING SYSTEMS LLC EIN 34-1952656 | Other fees Service code 99 | — | $40K |
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 | 10,789 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 19,679 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 30,468 | 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.