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 |
|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC. EIN 36-4291971 NONE | Contract Administrator Service code 13 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | $112K |
| WELLS FARGO ADVISORS EIN 27-1301141 NONE | Investment management Service code 28 | 888 PROSPECT STREET, SUITE 301 LA JOLLA, CA 92037 | $107K |
| REICH ADELL & CVITAN EIN 95-3082677 NONE | Legal Service code 29 | 3550 WILSHIRE BLVD., SUITE 2000 LOS ANGELES, CA 90010 | $13K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 10681 FOOTHILL BLVD, SUITE 300 RANCHO CUCAMONGA, CA 917303831 | $9K |
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 | 3,573 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 979 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,552 | 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.