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 |
|---|---|---|---|
| WILSON MCSHANE EIN 41-0956552 CONTRACT ADMIN | Contract Administrator; Direct payment from the plan Service code 13 | — | $242K |
| CIGNA EIN 59-1031071 CLAIMS PROCESSOR | Claims processing; Other services; Float revenue; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Contract Administrator; Participant communication Service code 12 | — | $237K |
| THE SEGAL COMPANY EIN 13-1975125 ACTUARY/CONSULT | Insurance brokerage commissions and fees; Actuarial; Consulting fees; Direct payment from the plan; Consulting (general) Service code 11 | — | $153K |
| ZIEGLER CAPITAL MANAGEMENT EIN 27-2347077 INVESTMENT MANAGER | Soft dollars commissions; Investment management; Investment management fees paid directly by plan Service code 28 | — | $142K |
| ARNOLD, NEWBOLD, WINTER, & JACKSON EIN 43-1174269 PLAN ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $113K |
| OUT OF NETWORK SAVINGS PROGRAM EIN 35-2041388 PREF PROV ORG | Claims processing; Direct payment from the plan Service code 12 | — | $37K |
| EXPRESS SCRIPTS EIN 43-1420563 PREF PROVIDER ORG. | Direct payment from the plan; Claims processing Service code 12 | — | $30K |
| RUBINBROWN LLP EIN 43-0765316 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $28K |
| CONSTRUCTION BENEFITS AUDITS CORP EIN 43-1244218 EMPLOYER AUDITS | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $26K |
| BMO HARRIS BANK N.A. EIN 36-2085229 CUSTODIAN | Custodial (securities); Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $19K |
| MEDICAL REVIEW INSTITUTE OF AMERICA EIN 87-0515201 MEDICAL REVIEW | Other services; Direct payment from the plan Service code 49 | — | $13K |
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 | 739 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 188 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 927 | 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.