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 |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 NONE | Non-monetary compensation; Claims processing; Direct payment from the plan; Contract Administrator; Other services; Participant communication; Float revenue Service code 12 | — | $428K |
| MERITAIN HEALTH NONE | Direct payment from the plan; Claims processing Service code 12 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $263K |
| EDWARD REH, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 1704 WINESAP LANE KIRKWOOD, MO 63122 | $175K |
| M. COLLOM EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $161K |
| A. HERZOG, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 816 S. BEMISTON ST. LOUIS, MO 63105 | $149K |
| HARTNETT REYES-JONES, LLC EIN 43-1205253 NONE | Direct payment from the plan; Legal Service code 29 | — | $142K |
| K. O'MARA EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $137K |
| DELTA DENTAL EIN 43-0908349 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Direct payment from the plan Service code 12 | — | $135K |
| COMMERCE TRUST COMPANY EIN 43-0356370 NONE | Custodial (securities); Investment management fees paid directly by plan; Shareholder servicing fees Service code 19 | — | $133K |
| M. MCCLIMENS EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $131K |
| MAXORPLUS PHARMACY BENEFIT NONE | Other services; Direct payment from the plan Service code 49 | 320 S. POLK ST. 200 AMARILLO, TX 79101 | $130K |
| ANDERS MINKLER HUBER & HELM LLP EIN 43-0831507 NONE | Direct payment from the plan; Accounting (including auditing); Consulting (general); Consulting fees Service code 10 | — | $122K |
| M. HEPBURN EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $120K |
| D. O'CONNELL EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $119K |
| M. REESE EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $117K |
| QUEST DIAGNOSTIC NONE | Direct payment from the plan; Other services Service code 49 | P.O. BOX 14730 ST. LOUIS, MO 63150 | $115K |
| T. BIELICKI EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $114K |
| R. ARBUTHNOT EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $114K |
| J. MCVEY EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $113K |
| J. SANSONE EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $112K |
| B. HOWELL EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $108K |
| SAV RX NONE | Other services; Direct payment from the plan Service code 49 | 224 NORTH PARK AVENUE FREMONT, NE 68025 | $104K |
| B. FLYNN EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $104K |
| PAUL B. HOFFMAN NONE | Direct payment from the plan; Other services Service code 49 | 11405 NEW HALLS FERRY FLORISSANT, MO 63033 | $102K |
| S. HUNT EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| M. DANCHUS EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| ASMED HEALTH PARTNERSHIP EIN 65-0456637 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $91K |
| N. BORDERS EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| RED CARD NONE | Direct payment from the plan; Claims processing Service code 12 | 10812 AMBASSADOR BLVD ST. LOUIS, MO 63132 | $89K |
| K. BUSHMAN EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| RAFI KEVORKIAN, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 522 N. NEW BALLAS RD, STE 317 ST. LOUIS, MO 63141 | $87K |
| L. KUHN, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 12111 BELLE MEADE ROAD ST. LOUIS, MO 63131 | $87K |
| L. SCHAFER EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| L. DELUCA EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| A. MOORE EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| M. SANDERS EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $81K |
| D. O'NEAL EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| P. GALLAGHER EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| C. LOCK EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
| L. O'MARA EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $75K |
| P. HIRSCHBUEHLER EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| J. OWENS EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $71K |
| K. MURPHY EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| PBIRX NONE | Direct payment from the plan; Other services Service code 49 | 612 WHEELERS FARMS ROAD MILFORD, CT 06461 | $69K |
| G. GREJTAK EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| J. DISKO EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| S. GEORGER EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| C. CHRISTIAN-BRICE EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $65K |
| J. BEARD EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| K. JOHNDROW EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $65K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,637 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,637 | 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.