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 |
|---|---|---|---|
| CAPFINANCIAL PARTNERS LLC DBA CAPTR INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | 4208 SIX FORKS RD STE 1700 RALEIGH NC RALEIGH, NC 27609 | $80K |
| EMPOWER ANNUITY INSURANCE COMPANY O RECORDKEEPER | Recordkeeping fees Service code 64 | 8515 EAST ORCHARD ROAD GREENWOOD VILLAGE, CO 80111 | $67K |
| FISHERBROYLES LLP ATTORNEY | Legal Service code 29 | PO BOX 735232 DALLAS TX DALLAS, TX 753735232 | $34K |
| PEARCE, BEVILL, LEESBURG, MOORE P.C AUDITOR | Accounting (including auditing) Service code 10 | 110 OFFICE PARK DR SUITE 100 BIRMINGHAM, AL 352232401 | $34K |
| PRINCIPAL FINANCIAL GROUP OTHER | Other fees Service code 99 | PO BOX 777 DES MOINES IA DES MOINES, IA 503020777 | $5K |
| QDRO CONSULTANTS COMPANY, LLC OTHER | Other fees Service code 99 | 3071 PEARL ROAD MEDINA OH MEDINA, OH 44256 | $500 |
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 | 353 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 132 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 4 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 511 | 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.