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 |
|---|---|---|---|
| SCHARF INVESTMENTS LLC EIN 26-3775085 INVESTMENT MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | — | $247K |
| FIDELITY INVESTMT INSTIT OP CO INC EIN 04-2647786 RECORDKEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication; Recordkeeping fees; Direct payment from the plan Service code 15 | — | $150K |
| PRICEWATERHOUSECOOPERS LLP EIN 13-4008324 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $46K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing; Participant communication Service code 12 | — | $39K |
| TOWERS WATSON DELAWARE INC EIN 53-0181291 ACTUARY | Direct payment from the plan; Actuarial Service code 11 | — | $31K |
| JPMORGAN CHASE BANK NA EIN 13-4994650 TRUSTEE | Trustee (directed); Custodial (securities); Float revenue; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 19 | — | $6K |
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 | 1,648 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 656 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,319 | 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.