No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE EIN 36-2739571 NONE | Plan Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $178K |
| UMR EIN 39-1995276 NONE | Plan Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $75K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Plan Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $74K |
| COORDINATED CARE PROGRAMS LLC EIN 20-8423895 NONE | Direct payment from the plan; Plan Administrator; Claims processing Service code 12 | — | $38K |
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Claims processing; Plan Administrator; Direct payment from the plan Service code 12 | — | $26K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $16K |
| AMERIBEN EIN 82-0497661 NONE | Plan Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $12K |
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 | 10,527 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,527 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 46 | $1.0M |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 46 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 46 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.