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 |
|---|---|---|---|
| UNITED HEALTHCARE EIN 41-1289245 NONE | Other services; Claims processing Service code 12 | — | $6.4M |
| US BANK NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | 1555 N. RIVERCENTER DR SUITE 300 MILWAUKEE, WI 53212 | $173K |
| CIGNA EIN 59-1031071 NONE | Other services; Non-monetary compensation; Claims processing; Direct payment from the plan; Float revenue; Participant communication; Contract Administrator Service code 12 | — | $154K |
| WEX, INC. NONE | Direct payment from the plan; Contract Administrator Service code 13 | 1700 E. GOLF ROAD #600 SCHAMBURG, IL 60173 | $95K |
| WILLIS WATSON EIN 26-0775680 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $50K |
| FORVIS MAZARS, LLP EIN 44-0160260 NONE | Direct payment from the plan; Foreign entity (e.g., an agent or broker, bank, insurance company, etc. not operating within jurisdictional boundaries of the United States); Accounting (including auditing) Service code 10 | — | $38K |
| CVS EIN 05-0340626 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $19K |
| EMPLOYEE BENEFITS GROUP, LLC EIN 73-1554797 NONE | Other services; Direct payment from the plan Service code 49 | — | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,878 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,878 | 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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.