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 INSURANCE COMPANIES, INC. EIN 35-0781558 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Direct payment from the plan; Claims processing; Other services Service code 12 | — | $3.7M |
| PRUDENTIAL INSURANCE CO. EIN 22-1211670 NONE | Insurance agents and brokers; Soft dollars commissions; Insurance services; Direct payment from the plan; Other investment fees and expenses Service code 22 | — | $1.7M |
| ELI LILLY AND COMPANY EIN 35-0470950 PLAN SPONSOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $102K |
| ERNST & YOUNG LLP EIN 34-6565596 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $37K |
| HMH CONSULTING EIN 56-2559267 NONE | Consulting (pension); Direct payment from the plan Service code 17 | — | $30K |
| PLANTE & MORAN PLLC EIN 38-1357951 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $26K |
| HEWITT ASSOCIATES, LLC EIN 36-2235791 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $13K |
| JPMORGAN CHASE BANK, N.A. EIN 13-4994650 NONE | Float revenue; Other investment fees and expenses Service code 62 | — | $7K |
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 | 9,445 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 9,445 | 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.