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 |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Other fees Service code 99 | — | $1.1M |
| THE SEGAL COMPANY, INC. EIN 13-1975125 NONE | Actuarial Service code 11 | — | $143K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Consulting (general) Service code 16 | — | $135K |
| K. GONZALEZ EIN 36-2688697 EMPLOYEE | Employee (plan) Service code 30 | — | $124K |
| S. ROMAN EIN 36-2688697 EMPLOYEE | Employee (plan) Service code 30 | — | $118K |
| SHARI HEMBREE EIN 36-2688697 EMPLOYEE | Employee (plan) Service code 30 | — | $101K |
| SAMANTHA HEMBREE EIN 36-2688697 EMPLOYEE | Employee (plan) Service code 30 | — | $94K |
| SIERRA INVESTMENT PARTNERS, INC. EIN 68-0370668 NONE | Investment management fees paid directly by plan; Investment management; Soft dollars commissions Service code 28 | — | $92K |
| A. WOJCIECHOWSKI EIN 36-2688697 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $79K |
| A. MCCLURE EIN 36-2688697 EMPLOYEE | Employee (plan) Service code 30 | — | $69K |
| C. BOGGS EIN 36-2688697 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| L. PALMSONE EIN 36-2688697 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| LOOMIS SAYLES TRUST COMPANY EIN 20-8080381 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $52K |
| BAUM SIGMAN AUERBACH & NEUMAN, LTD. EIN 36-2744057 NONE | Legal Service code 29 | — | $51K |
| GRAFF, BLANSKI & KIM,P.C. EIN 36-3331802 NONE | Accounting (including auditing) Service code 10 | — | $42K |
| ZELIS PAYMENTS HOLDINGS, LLC EIN 84-3069529 NONE | Other services Service code 49 | — | $40K |
| J. WITT EIN 36-2688697 FORMER PLAN ADMINISTRATOR | Employee (plan) Service code 30 | — | $39K |
| S. CURATOLA EIN 36-2688697 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| MARQUETTE ASSOCIATES, INC. EIN 36-3485298 NONE | Investment advisory (plan) Service code 27 | — | $35K |
| GLOBAL TRUST COMPANY EIN 26-3761443 NONE | Soft dollars commissions; Investment management fees paid directly by plan; Investment management Service code 28 | — | $34K |
| FORT WASHINGTON INVESTMENT ADVISORS EIN 31-1301863 NONE | Investment management fees paid directly by plan; Soft dollars commissions; Investment management Service code 28 | — | $23K |
| B. MULLANE EIN 36-2688697 EMPLOYEE | Employee (plan) Service code 30 | — | $17K |
| DENTAL NETWORK OF AMERICA EIN 36-3339483 NONE | Other fees Service code 99 | — | $15K |
| DATALYNX SPENGLER EIN 35-2384751 NONE | Consulting (general) Service code 16 | — | $14K |
| MESIROW INSURANCE SERVICE, INC. EIN 36-3429604 NONE | Other fees; Insurance brokerage commissions and fees Service code 53 | — | $10K |
| SCHIELE GRAPHICS, INC. EIN 36-2430120 NONE | Copying and duplicating Service code 36 | 1880 BUSSE ROAD ELK GROVE VILLAGE, IL 60007 | $8K |
| NATIONAL COOPERATIVE RX | Other fees Service code 99 | — | $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 | 1,423 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 154 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,577 | 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.