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 FLORIDA EIN 59-2015694 PLAN ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 1798 JACKSONVILLE, TN 322310014 | $414K |
| SYMETRA LIFE INSURANCE COMPANY INSURANCE PROVIDER | Insurance services Service code 23 | 777 108TH AVENUE NE, SUITE 1200 BELLEVUE, WA 980045135 | $274K |
| FIRST SERVICE CORP EIN 59-2506423 BENEFIT DEPT | Plan Administrator Service code 14 | — | $219K |
| SUN LIFE ASSURANCE OF CANADA EIN 81-0170040 PLAN ADMINISTRATOR | Claims processing Service code 12 | ONE SUN LIFE EXECUTIVE PARK WELLESLEY HILLS, MA 024815699 | $39K |
| ROBINSON BUSH CONSULTANT | Consulting fees Service code 70 | 21 PARK LAKE STREET ORLANDO, FL 32803 | $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 | 688 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 693 | 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.