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 |
|---|---|---|---|
| CROWELL MORING LLP EIN 52-1150358 NONE | Legal; Direct payment from the plan Service code 29 | — | $78K |
| SUBMITTABLE HOLDINGS, INC. NONE | Other fees; Direct payment from the plan Service code 50 | 111 N HIGGINS AVE STE 300 MISSOULA, MT 59802 | $64K |
| COMPREHENSIVE HEALTH PLAN SYSTEMS I EIN 47-4496373 NONE | Direct payment from the plan; Other fees Service code 50 | — | $63K |
| ANN SMITH COMMUNICATIONS EIN 20-6508364 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $56K |
| MOONEY, GREEN & SAINDON, P.C. EIN 52-1599698 NONE | Legal; Direct payment from the plan Service code 29 | — | $55K |
| REMOTE VISION, LLC EIN 20-3430237 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $29K |
| WITHUMSMITH+BROWN, P.C. EIN 22-2027092 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $28K |
| JERRY JONES EIN 52-1599698 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $25K |
| THOMAS MEANS EIN 52-1599698 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $25K |
| AON RISK SERVICES NONE | Other services; Direct payment from the plan Service code 49 | 200 E RANDOLPH ST CHICAGO, IL 60601 | $11K |
| VANGUARD EIN 23-1945930 NONE | Direct payment from the plan; Investment management; Investment management fees paid directly by plan Service code 28 | — | $6K |
| CANOPY THE WHARF NONE | Other services; Direct payment from the plan Service code 49 | 7930 JONES BRANCH DRIVE MCLEAN, VA 22102 | $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 | 75 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 75 | 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.