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 |
|---|---|---|---|
| MVI ADMINISTRATORS INC. EIN 33-0393692 ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | 2615 CAMINO DEL RIO SOUTH STE 201 SAN DIEGO, CA 92108 | $217K |
| SHEPPARD MULLIN EIN 95-1463164 PLAN COUNSEL | Direct payment from the plan; Legal Service code 29 | 333 SOUTH HOPE STREET 43RD FLOOR LOS ANGELES, CA 90071 | $81K |
| EIDE BAILLY LLP EIN 45-0250958 INDEPENDENT AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | 5675 RUFFIN ROAD STE 300 SAN DIEGO, CA 92123 | $18K |
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 | 1,467 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,467 | 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.