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 |
|---|---|---|---|
| HEALTH SMART BENEFIT SOLUTIONS EIN 36-4099199 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $2.2M |
| KEYSTONE PEER REVIEW ORGANIZATION EIN 23-2348176 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $2.1M |
| 1974 PENSION TRUST EIN 52-6150908 EMPLOYER | Other services; Accounting (including auditing); Employee (plan); Investment management; Legal; Direct payment from the plan Service code 10 | — | $1.7M |
| MORGAN, LEWIS & BOCKIUS LLP EIN 23-0891050 NONE | Legal; Direct payment from the plan Service code 29 | — | $785K |
| WITHUMSMITH+BROWN EIN 22-2027092 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $174K |
| TRUSTEE STAFF EIN 52-1805437 EMPLOYEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $140K |
| MOONEY GREEN SAINDON EIN 52-1182494 NONE | Legal; Direct payment from the plan Service code 29 | — | $87K |
| CCRC ACTUARIES, LLC EIN 52-2261050 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $56K |
| INTERIM HEALTHCARE OF SE OHIO, INC EIN 47-0947907 NONE | Direct payment from the plan; Consulting (general); Consulting fees Service code 16 | — | $50K |
| MARSH USA, INC EIN 36-1436000 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $45K |
| BDO USA, P.C. EIN 13-5381590 NONE | Direct payment from the plan; Consulting (general); Consulting fees Service code 16 | — | $39K |
| ARTHUR DIAMOND, INC EIN 52-0937528 NONE | Consulting (general); Direct payment from the plan; Consulting fees Service code 16 | — | $35K |
| BIG SANDY AREA DEVELOPMENT DISTRICT EIN 61-0671002 NONE | Direct payment from the plan; Consulting (general); Consulting fees Service code 16 | — | $31K |
| PRICE WATERHOUSE COOPERS EIN 13-5326270 NONE | Direct payment from the plan; Consulting fees; Consulting (general) Service code 16 | — | $30K |
| MICROSOFT CORPORATION EIN 91-1144442 NONE | Other services; Direct payment from the plan Service code 49 | — | $27K |
| POWERS, PYLES, SUTTER, VERVILLE EIN 52-1620214 NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $25K |
| INSIGHT DIRECT USA EIN 36-3948996 NONE | Direct payment from the plan; Other services Service code 49 | — | $24K |
| KELLY PRESS INC EIN 52-0975591 NONE | Copying and duplicating; Other services; Direct payment from the plan Service code 36 | — | $21K |
| VERIZON EIN 47-0751768 NONE | Other services; Direct payment from the plan Service code 49 | — | $21K |
| UNITED ACTUARIAL SERVICE EIN 35-2156428 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $18K |
| NORTHERN TRUST COMPANY EIN 36-1561860 NONE | Custodial (securities); Other fees; Direct payment from the plan; Account maintenance fees Service code 19 | — | $17K |
| PENSION BENEFIT INFORMATION EIN 94-2856521 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $14K |
| JONES, NANCY C. NONE | Direct payment from the plan; Contract Administrator Service code 13 | 2121 K STREET N.W. SUITE 350 WASHINGTON, DC 20037 | $13K |
| COMMUNITY NURSING SERVICES CORP. EIN 74-2534122 NONE | Consulting fees; Consulting (general); Direct payment from the plan Service code 16 | — | $10K |
| SUBROGATION SERVICES, LLC EIN 33-2496742 NONE | Other services; Direct payment from the plan; Consulting (general) Service code 16 | — | $9K |
| CHUBB & SON EIN 13-1963496 NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $8K |
| RELX INC. DBA LEXIS EIN 52-1471842 NONE | Direct payment from the plan; Other services Service code 49 | — | $8K |
| RESCHINI, JOSEPH NONE | Direct payment from the plan; Contract Administrator Service code 13 | 2121 K STREET N.W. SUITE 350 WASHINGTON, DC 20037 | $8K |
| RAPID7 LLC EIN 74-3111935 NONE | Other services; Direct payment from the plan Service code 49 | — | $8K |
| INFO-TECH RESEARCH EIN 20-4312071 NONE | Direct payment from the plan; Other services Service code 49 | — | $7K |
| VERIZON BUSINESS EIN 23-2743964 NONE | Other services; Direct payment from the plan Service code 49 | — | $7K |
| MARTEL, DIANNE, RN, NONE | Contract Administrator; Direct payment from the plan Service code 13 | 2121 K STREET N.W. SUITE 350 WASHINGTON, DC 20037 | $7K |
| RONCOLI, GUILLERMO NONE | Direct payment from the plan; Contract Administrator Service code 13 | 2121 K STREET N.W. SUITE 350 WASHINGTON, DC 20037 | $6K |
| DAVIE, KAREN NONE | Direct payment from the plan; Contract Administrator Service code 13 | 2121 K STREET N.W. SUITE 350 WASHINGTON, DC 20037 | $6K |
| BACKSTOP SOLUTIONS GROUP, LLC EIN 20-0199997 NONE | Direct payment from the plan; Other services Service code 49 | — | $6K |
| BULBIN, YURY NONE | Contract Administrator; Direct payment from the plan Service code 13 | 2121 K STREET N.W. SUITE 350 WASHINGTON, DC 20037 | $6K |
| ASCENTIS EIN 91-1630801 NONE | Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $5K |
| YANG, WEI-CHIEN NONE | Direct payment from the plan; Contract Administrator Service code 13 | 2121 K STREET N.W. SUITE 350 WASHINGTON, DC 20037 | $5K |
| KNOWLEDGELAKE, INC NONE | Direct payment from the plan; Other services Service code 49 | 555 MARYVILLE UNIVERSITY DRIVE ST. LOUIS, MO 63141 | $5K |
| BLOOMBERG FINANCE, L.P EIN 13-3417984 NONE | Other investment fees and expenses; Direct payment from the plan Service code 50 | — | $5K |
| STOVER, DALE R NONE | Direct payment from the plan; Contract Administrator Service code 13 | 2121 K STREET N.W. SUITE 350 WASHINGTON, DC 20037 | $5K |
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 | 4,019 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,019 | 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.