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 |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE CO EIN 36-2739571 NONE | Direct payment from the plan; Contract Administrator Service code 13 | 9900 BREN ROAD E MINNETONKA, MN 55343 | $261K |
| SOUTHERN BENEFIT ADMINSTRATORS INC EIN 62-1116095 NONE | Direct payment from the plan; Plan Administrator Service code 14 | 2001 CALDWELL DRIVE GOODLESVILLE, TN 370723589 | $175K |
| HANNON & ASSOCIATES EIN 59-2892813 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 2700 UNIVERSITY BLVD W STE A-2 JACKSONVILLE, FL 32217 | $50K |
| LOOMIS SAYLES EIN 04-3200030 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | ONE FINANCIAL CENTER BOSTON, MA 02111 | $45K |
| HORIZON ACTUARIAL SERVICES LLC EIN 26-1370698 NONE | Actuarial; Direct payment from the plan Service code 11 | 900 ASHWOOD PKWY STE 170 ATLANTA, GA 30338 | $12K |
| VENABLE LAW FIRM PA EIN 59-1824867 NONE | Legal; Direct payment from the plan Service code 29 | 7402 N 56TH STREET STE 380 TAMPA, FL 33617 | $11K |
| HOLBROOK AKEL COLD RAY REICHARD PA EIN 59-1197594 NONE | Legal; Direct payment from the plan Service code 29 | 1 INDEPENDENT DR STE 2301 JACKSONVILLE, FL 32202 | $9K |
| SEGAL MACRO ADVISORS EIN 12-2646110 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 400 GALLERIA PKWY STE 1470 ATLANTA, GA 303391700 | $6K |
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 | 817 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 817 | 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.