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 BENEFIT ADMINISTRATOR EIN 35-0781558 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Other services Service code 12 | 220 VIRGINIA AVENUE INDIANAPOLIS, IN 46204 | $2.3M |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Actuarial Service code 11 | 101 NORTH WACKER DRIVE, STE 500 CHICAGO, IL 60606 | $169K |
| MED-CARE MANAGEMENT INC EIN 88-0429522 NONE | Other services Service code 49 | 2090 PALM BEACH LAKES BLVD, STE 900 WEST PALM BEACH, FL 33409 | $167K |
| RREEF AMERICA LLC EIN 58-2364506 NONE | Investment management Service code 28 | 875 NORTH MICHIGAN CHICAGO, IL 60611 | $142K |
| CHERYL COTTRELL EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $112K |
| DAWN KASEMEYER EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $81K |
| ZIEGER CAPITAL MANAGEMENT EIN 27-2347077 NONE | Investment advisory (plan) Service code 27 | 501 NORTH BROADWAY ST. LOUIS, MO 63102 | $80K |
| JACQUELINE ELLINGER EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $64K |
| ASMED HEALTH EIN 27-4189010 NONE | Other services Service code 49 | 3230 W COMMERCIAL BLVD, STE 350 FORT LAUDERDALE, FL 33309 | $61K |
| KATRICIA HELTON EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $53K |
| JENNIFER VAUTERS EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $53K |
| IFM INVESTORS PTY LTD EIN 98-0569684 NONE | Foreign entity (e.g., an agent or broker, bank, insurance company, etc. not operating within jurisdictional boundaries of the United States); Investment management; Investment management fees paid indirectly by plan Service code 28 | 114 WEST 47TH STREET, 26TH FLOOR NEW YORK, NY 10036 | $51K |
| PAMELA MATHERLY EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $49K |
| MARQUETTE ASSOCIATES EIN 36-3485298 NONE | Investment advisory (plan) Service code 27 | 180 NORTH LASALLE STREET, STE 3500 CHICAGO, IL 60601 | $49K |
| BRITTANY KARANOVICH EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $48K |
| JAMIE BUNCH EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $48K |
| KATHY MCCOWEN EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $48K |
| SACKRIDER & COMPANY, INC. EIN 35-1327464 NONE | Accounting (including auditing) Service code 10 | 1925 WABASH AVENUE TERRE HAUTE, IN 47807 | $39K |
| DEBRA MCCOWEN EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $37K |
| CHRISTINA ELKINS EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $32K |
| FIRST FINANCIAL BANK EIN 35-0704860 NONE | Custodial (securities) Service code 19 | P.O. BOX 2122 TERRE HAUTE, IN 47802 | $29K |
| LEANN MALONE EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $29K |
| WRIGHT, SHAGLEY & LOWERY EIN 35-1388024 NONE | Legal Service code 29 | 500 OHIO STREET TERRE HAUTE, IN 47807 | $18K |
| ASHLEY LEE EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $13K |
| HARVEY & STUCKEL EIN 37-1064984 NONE | Legal Service code 29 | 101 SW ADAMS STREET PEORIA, IL 61602 | $10K |
| JOCELYN DUGGER EIN 35-0917610 EMPLOYEE | Employee (plan) Service code 30 | 1100 POPLAR STREET TERRE HAUTE, IN 47807 | $9K |
| ROMOLO & ASSOCIATES EIN 37-1077733 NONE | Accounting (including auditing) Service code 10 | 1700 W LUTHY DRIVE PEORIA, IL 61615 | $8K |
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 | 4,390 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,290 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,680 | 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.