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 |
|---|---|---|---|
| UNITEDHEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | — | $3.1M |
| ALIGHT SOLUTIONS EIN 36-2235791 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Direct payment from the plan Service code 15 | — | $967K |
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 NONE | Direct payment from the plan; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | — | $186K |
| HARTFORD EIN 06-0383750 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $147K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 06-0303370 NONE | Contract Administrator; Non-monetary compensation; Other services; Direct payment from the plan; Claims processing; Participant communication; Float revenue Service code 12 | — | $137K |
| LIFEWORKS US INC EIN 81-1114266 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $76K |
| TOWERS WATSON DELAWARE INC. EIN 27-0676603 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $14K |
| JP MORGAN CHASE BANK, NA EIN 13-4994650 CUSTODIAN | Distribution (12b-1) fees; Soft dollars commissions; Direct payment from the plan; Other fees; Other commissions; Float revenue Service code 50 | — | $12K |
| WELCOA NONE | Participant communication; Direct payment from the plan Service code 38 | 17002 MARCY STREET SUITE 140 OMAHA, NE 68118 | $7K |
| ELK GROVE GRAPHICS NONE | Direct payment from the plan; Participant communication Service code 38 | 1200 CHASE AVENUE ELK GROVE VILLAGE, IL 60007 | $7K |
| OGLETREE EIN 57-1044820 NONE | Legal; Direct payment from the plan Service code 29 | — | $7K |
| JP MORGAN CHASE, NA | Float revenue Service code 62 | — | $4K |
| CIGNA | Claims processing; Contract Administrator; Direct payment from the plan; Participant communication; Float revenue; Other services; Non-monetary compensation; Named fiduciary Service code 12 | — | $0 |
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 | 4,756 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 926 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 823 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,505 | 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.