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 |
|---|---|---|---|
| LISA CARTER EIN 58-1370485 EMPLOYEE | Employee (plan) Service code 30 | — | $134K |
| DANA HARRELL EIN 58-1370485 EMPLOYEE | Employee (plan) Service code 30 | — | $97K |
| UFCW BENEFITS ADMINISTRTION, LLC EIN 77-0613772 ADMINISTRATOR | Contract Administrator Service code 13 | — | $96K |
| HADLEY M RECOR EIN 58-1370485 EMPLOYEE | Employee (plan) Service code 30 | — | $96K |
| JAMMIE TAIRE EIN 58-1370485 EMPLOYEE | Employee (plan) Service code 30 | — | $88K |
| JON GREEN EIN 58-1370485 EMPLOYEE | Employee (plan) Service code 30 | — | $86K |
| MELISSA STATON EIN 58-1370485 EMPLOYEE | Legal Service code 29 | — | $57K |
| DENNIS G. JENKINS, CPA EIN 20-5886120 EMPLOYEE | Employee (plan) Service code 30 | — | $43K |
| CHARBE DUNCAN EIN 58-1370485 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| STANLEY JOHNSON EIN 58-1370485 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| SLEVIN & HART EMPLOYEE | Employee (plan) Service code 30 | — | $39K |
| MONZERRATH MEDINA EIN 58-1370485 EMPLOYEE | Employee (plan) Service code 30 | — | $36K |
| KRYSTAL HAYNES EIN 58-1370485 EMPLOYEE | Employee (plan) Service code 30 | — | $27K |
| BHA CONSULTING, LLC EIN 26-1384808 CONSULTANT | Consulting (general) Service code 16 | — | $6K |
| ERIC TALOR EIN 58-2141936 UNION TRUSTEE | Trustee (individual) Service code 20 | — | $0 |
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 | 16,690 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 16,690 | 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.