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 |
|---|---|---|---|
| MEGHAN COWAN EIN 52-0953443 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 6610 TRIBUTARY STREET SUITE 202 BALTIMORE, MD 21224 | $170K |
| SIMON E. DAVIS EIN 52-0953443 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 6610 TRIBUTARY STREET SUITE 202 BALTIMORE, MD 21224 | $160K |
| JULIE MITCHELL EIN 52-0953443 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 6610 TRIBUTARY STREET SUITE 202 BALTIMORE, MD 21224 | $150K |
| ANTWON LEMON EIN 52-0953443 PLAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 6610 TRIBUTARY STREET SUITE 202 BALTIMORE, MD 21224 | $45K |
| PBMARES, LLP EIN 54-0737372 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 500 E PRATT STREET SUITE 525 BALTIMORE, MD 21202 | $29K |
| ABATO, RUBENSTEIN & ABATO, PA EIN 52-0904713 NONE | Legal; Direct payment from the plan Service code 29 | 809 GLENEAGLES COURT SUITE 320 BALTIMORE, MD 21286 | $20K |
| CHUCK'S PRINTING & BLUELINE SERVICE EIN 52-1233071 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 1110 CRAIN HWY SW GLEN BURNIE, MD 21061 | $11K |
| STA OF BALTIMORE INFO SERVICES, INC EIN 52-1331539 NONE | Other services; Direct payment from the plan Service code 49 | 8615 RIDGELYS CHOICE DRIVE SUITE 20 BALTIMORE, MD 21236 | $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 | 1,156 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,156 | 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."
No prospect flags tripped on this filing.