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 |
|---|---|---|---|
| EMPLOYERS - ILA N.C PORTS WELFARE EIN 58-2126333 AFFILIATED SERVICE FUND | Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Direct payment from the plan Service code 10 | P O BOX 1116 WILMINGTON, NC 28402 | $145K |
| WAYNE RICHARDSON EIN 58-6153337 CONTAINER INSPECTOR | Employee (plan); Direct payment from the plan Service code 30 | — | $106K |
| TJS DEEMER DANA LLP EIN 58-2663273 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | 118 PARK OF COMMERCE DR. SAVANNAH, GA 31405 | $14K |
| EVEREST NATIONAL INSURANCE COMPANY EIN 22-2660372 INSURANCE | Direct payment from the plan; Insurance agents and brokers Service code 22 | 477 MARTINSVILLE RD LIBERTY CORNER, NJ 07938 | $6K |
| WELLS FARGO BANK, N.A. EIN 94-1347393 DIRECTED TRUSTEE/CUSTDN | Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Investment management fees paid indirectly by plan Service code 21 | — | $4K |
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 | 288 | 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) | 288 | 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.