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 |
|---|---|---|---|
| OHIO DENTAL INSURANCE AGENGY NONE | Insurance brokerage commissions and fees Service code 53 | 1370 DUBLIN ROAD COLUMBUS, OH 43215 | $846K |
| MEDICAL MUTUAL SERVICES NONE | Claims processing Service code 12 | 15885 W. SPRAGUE ROAD STRONGSVILLE, OH 44136 | $674K |
| LEWIS & ELLIS NONE | Actuarial Service code 11 | 11225 COLLEGE BLVD. SUITE 320 OVERLAND PARK, KS 66210 | $103K |
| SELF INSURED SERVICES COMPANY NONE | Accounting (including auditing) Service code 10 | 800 MAIN STREET DUBUQUE, IA 52001 | $34K |
| BENNETT THRASHER LLP NONE | Accounting (including auditing) Service code 10 | 3300 RIVERWOOD PARKWAY SUITE 700 ATLANTA, GA 30339 | $32K |
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 | 1,322 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,322 | 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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.