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 |
|---|---|---|---|
| CVS HEALTH EIN 05-0340626 NONE | Claims processing Service code 12 | 695 GEORGE WASHINGTON HIGHWAY LINCOLN, RI 02865 | $60.9M |
| HEALTHSMART BENEFIT SOLUTIONS EIN 36-4099199 NONE | Claims processing Service code 12 | — | $1.5M |
| HEALTHSMART CARE MANAGEMENT SOLUTIO EIN 75-2960859 NONE | Claims processing Service code 12 | — | $320K |
| EBERTS & HARRISON EIN 52-0816262 | Insurance agents and brokers Service code 22 | — | $38K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Custodial (securities); Investment management; Accounting (including auditing) Service code 10 | 30 N. LASALLE STREET CHICAGO, IL 60602 | $37K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | 7501 WISCONSIN AVENUE BETHESDA, MD 20814 | $20K |
| KELLY PRESS, INC EIN 52-0975591 NONE | Copying and duplicating Service code 36 | — | $16K |
| HORIZON ACTUARIAL EIN 26-1370698 NONE | Actuarial Service code 11 | — | $15K |
| MOONEY GREEN SAINDON MURPHY | Legal Service code 29 | 1920 L STREET NW SUITE 400 WASHINGTON, DC 20036 | $5K |
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 | 111 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 111 | 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.