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 |
|---|---|---|---|
| UNITED HEALTHCARE GROUP EIN 36-2739571 NONE | Float revenue Service code 62 | PO BOX 29675 HOT SPRINGS, AR 71903 | $2.5M |
| ANTHEM INSURANCE COMPANIES, INC 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 | $1.1M |
| TIM THACKER EIN 35-1063466 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 3040 TERRE HAUTE, IN 47803 | $114K |
| MED-CARE MANAGEMENT, INC. EIN 88-0429522 NONE | Other services Service code 49 | 2090 PALM BEACH LAKES BLVD SUITE 900 WEST PALM BEACH, FL 33409 | $82K |
| LEGG MASON PRIVATE PORTFOLIO GROUP EIN 20-5991122 NONE | Consulting (general) Service code 16 | 620 8TH AVE NEW YORK, NY 10018 | $73K |
| STEPHANIE MORGAN EIN 35-1063466 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 3040 TERRE HAUTE, IN 47803 | $53K |
| SUSAN HURLEY EIN 35-1063466 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 3040 TERRE HAUTE, IN 47803 | $53K |
| UNITED ACTUARIAL SERVICES, INC. EIN 35-2156428 NONE | Actuarial Service code 11 | 11590 NORTH MERIDIAN STREET CARMEL, IN 460324529 | $50K |
| CALEB MOORE EIN 35-1063466 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 3040 TERRE HAUTE, IN 47803 | $50K |
| DAWN MCBRIDE EIN 35-1063466 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 3040 TERRE HAUTE, IN 47803 | $50K |
| JORAN FERRIS EIN 35-1063466 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 3040 TERRE HAUTE, IN 47803 | $45K |
| MORGAN STANLEY SMITH BARNEY EIN 26-4310632 NONE | Consulting (general) Service code 16 | 401 WABASH AVENUE TERRE HAUTE, IN 47807 | $41K |
| REBECCA MEEKER EIN 35-1063466 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 3040 TERRE HAUTE, IN 47803 | $39K |
| MEGAN LUCAS EIN 35-1063466 EMPLOYEE | Employee (plan) Service code 30 | PO BOX 3040 TERRE HAUTE, IN 47803 | $28K |
| SACKRIDER & COMPANY, INC. EIN 35-1327464 NONE | Accounting (including auditing) Service code 10 | 1925 WABASH AVENUE TERRE HAUTE, IN 47807 | $26K |
| WRIGHT, SHAGLEY, LOWRY, P.C. EIN 20-8333939 NONE | Legal Service code 29 | 500 OHIO STREET TERRE HAUTE, IN 47807 | $17K |
| TERRELL & MARDIS PC CPAS EIN 35-1615881 NONE | Accounting (including auditing) Service code 10 | 465 S 25TH STREET TERRE HAUTE, IN 47803 | $9K |
| TIC INTERNATIONAL CORPORATION EIN 13-2600875 NONE | Consulting (general) Service code 16 | 11590 NORTH MERIDIAN STREET SUITE 600 CARMEL, IN 46032 | $9K |
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 | 2,125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,250 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,375 | 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.