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 |
|---|---|---|---|
| UNITEDHEALTHCARE EIN 36-2739571 NONE | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $3.2M |
| WITHUMSMITH+BROWN, P.C. EIN 22-2027092 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $451K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Other fees; Contract Administrator; Claims processing Service code 12 | — | $198K |
| TRUIST BANK EIN 56-1074313 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $41K |
| WILLIS TOWERS WATSON EIN 53-0181291 NONE | Actuarial Service code 11 | — | $21K |
| MCMC, LLC EIN 14-1847542 NONE | Consulting (general) Service code 16 | — | $16K |
| REMEDY ANALYTICS, INC. EIN 45-3151617 NONE | Consulting (general) Service code 16 | — | $13K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,917 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,917 | 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.