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 |
|---|---|---|---|
| KEYSTONE PEER REVIEW ORGANIZATION EIN 23-2348176 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $2.5M |
| HEALTHSMART BENEFIT SOLUTIONS EIN 36-4099199 NONE | Contract Administrator Service code 13 | — | $2.3M |
| 1974 PENSION TRUST EIN 52-6150908 EMPLOYER | Legal; Accounting (including auditing); Employee (plan); Other services Service code 10 | — | $911K |
| MORGAN LEWIS AND BOCKIUS LLP EIN 23-0891050 NONE | Legal Service code 29 | — | $314K |
| MOONEY GREEN SAINDON EIN 52-1182494 NONE | Legal Service code 29 | — | $229K |
| WITHUMSMITH+BROWN EIN 22-2027092 NONE | Accounting (including auditing) Service code 10 | — | $120K |
| TRUSTEES STAFF EIN 52-1805437 EMPLOYEES | Trustee (individual) Service code 20 | — | $81K |
| CCRC ACTUARIES, LLC EIN 52-2261050 NONE | Actuarial Service code 11 | — | $43K |
| VERIZON EIN 47-0751768 NONE | Other services Service code 49 | — | $35K |
| BIG SANDY AREA DEVELOPMENT EIN 61-0671002 NONE | Consulting fees; Consulting (general) Service code 16 | — | $30K |
| POWERS, PYLES, SUTTER & VERVILLE EIN 52-1620214 NONE | Legal Service code 29 | — | $23K |
| NORTHERN TRUST COMPANY EIN 36-1561860 NONE | Account maintenance fees; Other fees; Custodial (securities) Service code 19 | — | $22K |
| BEARER NANCY EIN 20-3966796 NONE | Consulting (general) Service code 16 | — | $17K |
| LEXIS NEXIS EIN 52-1471842 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $16K |
| UNITED ACTUARIAL SERVICE EIN 32-2156428 NONE | Actuarial Service code 11 | — | $15K |
| SAS INSTITUTE INC EIN 56-1133017 NONE | Other services Service code 49 | — | $15K |
| SOVO COMPLIANCE LLC EIN 46-1379693 NONE | Other services Service code 49 | — | $14K |
| HOME NURSING AGENCY EIN 25-1188570 NONE | Consulting fees; Consulting (general) Service code 16 | — | $13K |
| KELLY PRESS INC EIN 52-0975591 NONE | Other services; Copying and duplicating Service code 36 | — | $12K |
| COMMUNITY NURSING SERVICES CORP EIN 74-2534122 NONE | Consulting (general); Consulting fees Service code 16 | — | $12K |
| MILLIMAN INC EIN 91-0675641 NONE | Actuarial Service code 11 | — | $11K |
| SHAWNEE HEALTH SERVICE EIN 37-0966854 NONE | Consulting (general) Service code 16 | — | $9K |
| VONAGE BUSINESS EIN 20-5093831 NONE | Other services Service code 49 | — | $8K |
| INSIGHT DIRECT USA EIN 36-3948996 NONE | Other services Service code 49 | — | $7K |
| MICROSOFT CORPORATION EIN 91-1144442 NONE | Other services Service code 49 | — | $6K |
| LLUMOS EIN 45-5355575 NONE | Consulting (general) Service code 16 | — | $5K |
| QUINN CONNOR WEAVER EIN 63-0917236 NONE | Legal Service code 29 | — | $5K |
| HEALTHCARE MANAGEMENT EIN 20-2408500 NONE | Consulting (general); Consulting fees Service code 16 | — | $5K |
| CVS PHARMACY, INC EIN 05-0340626 NONE | Claims processing Service code 12 | — | $0 |
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 | 4,572 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,572 | 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.