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 EIN 59-1031071 CONTRACT ADMINISTRATOR | Claims processing; Non-monetary compensation; Other services; Participant communication; Named fiduciary; Contract Administrator; Direct payment from the plan; Float revenue Service code 12 | — | $301K |
| WILSON MCSHANE CORPORATION EIN 41-0956522 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $259K |
| ARNOLD, NEWBOLD, SOLLARS & HOLLINS, EIN 43-1174269 PLAN ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $110K |
| THE SEGAL COMPANY EIN 13-1975125 CONSULTANT/ACTUARY | Actuarial; Direct payment from the plan Service code 11 | — | $109K |
| ZIEGLER CAPITAL MANAGEMENT, LLC EIN 85-0597999 INVESTMENT MANAGER | Securities brokerage commissions and fees; Investment management fees paid directly by plan; Soft dollars commissions; Investment management Service code 28 | — | $59K |
| CONSTRUCTION BENEFITS AUDIT CORP EIN 43-1244218 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $41K |
| BMO HARRIS BANK N.A. EIN 36-2085229 CUSTODIAN | Custodial (other than securities); Direct payment from the plan; Float revenue; Finders' fees / placement fees; Investment management; Securities brokerage commissions and fees; Investment management fees paid directly by plan; Distribution (12b-1) fees Service code 18 | — | $31K |
| RUBINBROWN LLP EIN 43-0765316 PLAN AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $30K |
| BLUE CROSS BLUE SHIELD EIN 43-1257251 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing; Participant communication; Named fiduciary; Float revenue; Direct payment from the plan; Non-monetary compensation; Other services Service code 12 | — | $22K |
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 | 753 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 240 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 993 | 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.