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 |
|---|---|---|---|
| BLUE CROSS/ BLUE SHIELD EIN 36-1236610 NONE | Other commissions; Claims processing; Contract Administrator; Other fees Service code 12 | — | $770K |
| OGLETREE, DEAKINS, NASH, SMOAK & ST EIN 57-1044820 NONE | Legal Service code 29 | — | $115K |
| ALAN JOSEPH EIN 36-2226396 EMPLOYEE | Employee (plan) Service code 30 | — | $98K |
| JOHNSON & KROL EIN 36-4342024 NONE | Legal Service code 29 | — | $95K |
| THE SEGAL COMPANY INC. EIN 94-1503999 NONE | Actuarial Service code 11 | — | $90K |
| KAREN FARIAS EIN 36-2226396 EMPLOYEE | Employee (plan) Service code 30 | — | $84K |
| JAYNE PANKOVSKI EIN 36-2226396 EMPLOYEE | Employee (plan) Service code 30 | — | $81K |
| NATIONAL INVESTMENT SERVICES EIN 80-0169636 NONE | Investment management Service code 28 | — | $76K |
| COMPSYCH EIN 36-3739783 NONE | Claims processing Service code 12 | — | $74K |
| CHRISTINE NIELSEN EIN 36-2226396 EMPLOYEE | Employee (plan) Service code 30 | — | $72K |
| CATHY SLATER EIN 36-2226396 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| MEDICAL COST MANAGEMENT EIN 36-3445315 NONE | Consulting (general) Service code 16 | — | $60K |
| JULIE RACHAL EIN 36-2226396 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| LEGACY PROFESSIONALS, LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $41K |
| BASYS EIN 52-1796473 NONE | Consulting (general) Service code 16 | — | $33K |
| DENTAL NETWORK OF AMERICA LLC EIN 36-3339483 NONE | Claims processing Service code 12 | — | $17K |
| EVERACTIVE SOLUTIONS EIN 27-0988892 NONE | Consulting (general) Service code 16 | — | $17K |
| SEGAL MARCO ADVISORS EIN 36-3555078 NONE | Consulting (general) Service code 16 | — | $16K |
| WELLS FARGO EIN 94-1347393 NONE | Custodial (securities) Service code 19 | — | $14K |
| BANK OF AMERICA EIN 94-1687665 NONE | Custodial (securities) Service code 19 | — | $12K |
| THE UNION LIFE INSURANCE CO EIN 13-1423090 NONE | Investment management; Other commissions Service code 28 | — | $11K |
| EYEMED EIN 86-0773195 NONE | Claims processing Service code 12 | — | $8K |
| BANSLEY & KIENER, LLP EIN 36-2152389 NONE | Accounting (including auditing) Service code 10 | — | $8K |
| MEDICAL REVIEW INSTITUTE EIN 87-0515201 NONE | Consulting (general) Service code 16 | — | $7K |
| FAIR HEALTH INC. EIN 90-0524293 NONE | Consulting (general) Service code 16 | — | $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 | 1,973 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 133 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,106 | 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.