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 |
|---|---|---|---|
| MORGAN STANLEY SMITH BARNEY EIN 26-4310632 NONE | Custodial (securities); Direct payment from the plan; Investment advisory (plan) Service code 19 | — | $100K |
| TIC INTERNATIONAL CORPORATION EIN 13-2600875 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Direct payment from the plan; Contract Administrator Service code 10 | — | $13K |
| UNITED ACTUARIAL SERVICES EIN 13-2600875 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $13K |
| BENDA, GRACE, STULZ & COMPANY, P.C. EIN 38-2284921 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $11K |
| MASSACHUSETTS MUTUAL LIFE INS. CO. EIN 04-1590850 NONE | Direct payment from the plan; Contract Administrator; Investment management; Investment management fees paid directly by plan Service code 13 | — | $9K |
| SACHS WALDMAN PROFESSIONAL CORP. EIN 38-1905521 NONE | Legal; Direct payment from the plan Service code 29 | — | $8K |
| APEX CAPITAL MANAGEMENT NONE | Investment management fees paid indirectly by plan; Investment management Service code 28 | 10050 INNOVATION DR, 120 DAYTON, OH 45342 | $0 |
| DELAWARE CAPITAL NONE | Investment management fees paid indirectly by plan; Investment management Service code 28 | 2005 MARKET STREET PHILADELPHIA, PA 191037094 | $0 |
| INVESCO INVESTMENT SERVICES, INC. NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | P.O. BOX 219078 KANSAS CITY, MO 641219078 | $0 |
| THE LONDON COMPANY NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | 1800 BAYBERRY CT 301 RICHMOND, VA 23226 | $0 |
| WESTERN ASSET MANAGEMENT NONE | Investment management; Investment management fees paid indirectly by plan Service code 28 | 385 EAST COLORADO BLVD. PASEDENA, CA 91101 | $0 |
| WINSLOW CAPITAL MANAGEMENT, LLC NONE | Investment management fees paid indirectly by plan; Investment management Service code 28 | 80 SOUTH EIGHT STREET MINNEAPOLIS, MN 55402 | $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 | 157 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 82 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 237 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 13 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 489 | 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.