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 |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $886K |
| WILLIAM C. EARHART CO. INC EIN 93-0509592 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $804K |
| EYEMED VISION CARE, LLC EIN 31-1656473 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $170K |
| DELTA DENTAL OF D.C. EIN 52-1479587 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $94K |
| ELIXIR RX SOLUTIONS, LLC EIN 90-1011712 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $91K |
| BEYER-BARBER COMPANY EIN 23-2503024 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $40K |
| O'DONOGHUE & O'DONOGHUE, LLP EIN 53-0120528 NONE | Legal; Direct payment from the plan Service code 29 | — | $35K |
| HALEY & ASSOCIATES, LLC CPA EIN 55-0810153 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $32K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $14K |
| VOYA INVESTMENT MANAGEMENT CO., LLC EIN 06-1440627 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $13K |
| MEKETA FIDUCIARY MANAGEMENT EIN 47-2126910 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $11K |
| AON INVESTMENTS USA INC. EIN 36-3109431 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $11K |
| COMERICA EIN 42-1741646 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $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 | 1,829 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 556 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,385 | 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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.