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 CORP EIN 41-0956552 THIRD PARTY ADMINISTRATOR | Claims processing; Contract Administrator; Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $319K |
| BLUE CROSS BLUE SHIELD EIN 43-1257251 PPO | Claims processing; Direct payment from the plan Service code 12 | — | $235K |
| ARNOLD, NEWBOLD, SOLLARS & HOLLINS EIN 43-1174269 FUND LEGAL COUNSEL | Direct payment from the plan; Legal Service code 29 | — | $129K |
| SEGAL CONSULTING EIN 13-1975125 PLAN CONSULTANT | Consulting (general); Direct payment from the plan Service code 16 | — | $102K |
| CONSTRUCTION BENEFIT AUDIT CORP EIN 43-1244218 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $31K |
| COMMERCE TRUST CO EIN 44-0206815 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $15K |
| SSC CPAS, P.A. EIN 43-1215584 FUND AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $14K |
| SEGAL MARCO ADVISORS EIN 13-2646110 INVESTMENT CONSULTANT | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $5K |
| STATE STREET BANK EIN 04-1867445 CUSTODIAL | Custodial (securities); Direct payment from the plan Service code 19 | — | $3K |
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 | 524 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 228 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 752 | 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.