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 |
|---|---|---|---|
| MEDOVA HEALTHCARE TPA | Plan Administrator; Contract Administrator; Claims processing Service code 12 | 345 N RIVERVIEW STREET SUITE 120 WICHITA, KS 67203 | $31K |
| HEAD CAPITAL ADVISORS BROKER | Insurance agents and brokers Service code 22 | 2840 HILLCREEK DRIVE AUGUSTA, GA 30909 | $25K |
| BENEFIT PLAN ADMINISTRATORS, INC. EIN 54-1419753 TPA | Claims processing Service code 12 | — | $16K |
| CREATIVE BENEFIT CONSULTANTS LLC AGENT | Insurance agents and brokers Service code 22 | 25055 W 105TH TERR OLATHE, KS 66061 | $10K |
| NIPC BROKER | Insurance agents and brokers Service code 22 | 8670 W CHEYENNE AVENUE #120 LAS VEGAS, NV 89129 | $10K |
| MULTIPLAN INC- PHCS NETWORK PROVIDER | Insurance services; Insurance agents and brokers Service code 22 | P.O. BOX 29380 GENERAL POST OFFICE NEW YORK, NY 10087 | $6K |
| TELEDOC TELEMEDICINE | Contract Administrator Service code 13 | 1641 JEFFERSON AVE 7TH FL MIAMI BEACH, FL 22139 | $5K |
| FIRST HEALTH N/A | Contract Administrator Service code 13 | 23291 NETWORK PL CHICAGO, IL 60673 | $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 | 259 | 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) | 259 | 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.