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 | Contract Administrator; Claims processing; Other services Service code 12 | — | $1.1M |
| WILSON MCSHANE EIN 41-0956552 NONE | Contract Administrator; Copying and duplicating; Other services Service code 13 | — | $841K |
| JOHNSON & KROL EIN 36-4342024 NONE | Legal Service code 29 | — | $181K |
| VALENZ CARE EIN 81-5149270 NONE | Consulting (general) Service code 16 | — | $118K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Actuarial Service code 11 | — | $118K |
| NATIONAL INVESTMENT SERVICES EIN 84-3937993 NONE | Investment management Service code 28 | — | $87K |
| COMPSYCH CORPORATION EIN 36-3739783 NONE | Claims processing Service code 12 | — | $85K |
| LEGACY PROFESSIONALS, LLP EIN 32-0043599 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing) Service code 10 | — | $67K |
| SEGALL BRYANT & HAMILL EIN 35-2679129 NONE | Investment management Service code 28 | — | $55K |
| MORGAN, LEWIS AND BOCKIUS LLP EIN 23-0891050 NONE | Legal Service code 29 | — | $49K |
| DENTAL NETWORK OF AMERICA LLC EIN 36-3339483 NONE | Claims processing Service code 12 | — | $27K |
| BMO HARRIS BANK EIN 36-2085229 NONE | Custodial (securities); Float revenue Service code 19 | — | $19K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan) Service code 27 | — | $14K |
| EYEMED VISION CARE, LLC EIN 31-1656473 NONE | Claims processing Service code 12 | — | $12K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Direct payment from the plan; Investment management fees paid indirectly by plan; Custodial (securities) Service code 19 | — | $11K |
| THE UNION LABOR LIFE INS. CO. EIN 13-1423090 NONE | Investment management; Other commissions Service code 28 | — | $9K |
| FAIR HEALTH INC. EIN 90-0524293 NONE | Consulting (general) Service code 16 | — | $8K |
| CVS PHARMACY, INC EIN 05-0340626 NONE | Claims processing; Other commissions 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 | 2,272 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 161 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,433 | 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.