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 |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF GEORGIA EIN 58-0469845 NONE | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $1.2M |
| SIRIUS AMERICA INSURANCE COMPANY EIN 13-2997499 NONE | Contract Administrator Service code 13 | — | $951K |
| PARAGON BENEFITS, INC. EIN 58-1862304 NONE | Claims processing Service code 12 | — | $468K |
| BLUE CROSS BLUE SHIELD OF ALABAMA EIN 63-0103830 NONE | Claims processing Service code 12 | — | $310K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 NONE | Contract Administrator Service code 13 | — | $76K |
| TELADOC EIN 04-3705970 NONE | Contract Administrator Service code 13 | — | $75K |
| ENVOLVE PHARMACY EIN 77-0578529 NONE | Claims processing Service code 12 | — | $53K |
| ROBINSON, GRIMES & CO., P.C. EIN 58-1374304 NONE | Accounting (including auditing) Service code 10 | — | $34K |
| MILLIMAN EIN 91-0675641 NONE | Actuarial Service code 11 | — | $27K |
| HUGHSTON HEALTH EIN 58-1155460 NONE | Other fees Service code 99 | — | $14K |
| ERNST & YOUNG EIN 34-6565596 NONE | Accounting (including auditing) Service code 10 | — | $8K |
| KOHLL'S PHARMACY & HOMECARE EIN 47-0532015 NONE | Other fees Service code 99 | — | $7K |
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 | 4,094 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 48 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,142 | 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.