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 |
|---|---|---|---|
| UNION LABOR LIFE INSURANCE CO EIN 13-1423090 NONE | Direct payment from the plan; Insurance services Service code 23 | 8403 COLESVILLE RD SILVER SPRING, MD 20910 | $288K |
| AMERICAN BENEFIT CORPORATION EIN 55-0672859 NONE | Direct payment from the plan; Contract Administrator Service code 13 | 500 VIRGINIA STREET EAST SUITE 525 CHARLESTON, WV 25301 | $147K |
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 1351 W M. HOWARD TAFT ROAD CINCINNATI, OH 452061721 | $121K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 NONE | Claims processing; Direct payment from the plan Service code 12 | 7400 W. CAMPUS ROAD, F-510 NEW ALBANY, OH 43054 | $24K |
| GRAY, GRIFFITH AND MAYS EIN 55-0621482 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 707 VIRGINIA STREET, EAST, SUITE 40 CHARLESTON, WV 25301 | $15K |
| KRAMER WARNER ASSOCIATES, INC NONE | Direct payment from the plan; Insurance services Service code 23 | 3545 RHOADS AVENUE NEWTOWN SQUARE, PA 19073 | $14K |
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 | 264 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 149 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 413 | 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.