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 EIN 36-1236610 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $1.7M |
| A&S FINANCIAL SERVICES, LLC EIN 27-4188863 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $226K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $110K |
| ROBERT KIME EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $106K |
| KATHY MORRISON EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $101K |
| JON BALTZELL EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $89K |
| RENEE VAUSE EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $85K |
| EXCEL CARE EIN 36-3668948 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $78K |
| KIMBERLY BRASIOLA EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $63K |
| JUSTIN WALLACE EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $61K |
| MICHELLE LANDTROOP EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $56K |
| MONAGHAN & ASSOCIATES EIN 73-1462892 NONE | Legal; Direct payment from the plan Service code 29 | — | $49K |
| BONNIE ROBERSON EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $48K |
| LISA RAIBURN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $45K |
| CANDICE GRAHAM EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $45K |
| JEFFREY PARKS EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $45K |
| REBECCA WINSTEAD EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $44K |
| BROOKE STEPHENS EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $44K |
| DENNIS HUGGINS EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $44K |
| THE SEGAL COMPANY EIN 13-2619259 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $43K |
| DENTAL NETWORK OF AMERICA EIN 36-3339483 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $39K |
| CVS CAREMARK EIN 75-2882129 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $31K |
| RUBINBROWN LLP EIN 43-0765316 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $27K |
| SEGAL ROGERSCASEY EIN 13-2646110 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $25K |
| JAMES, POTTS, & WULFERS, INC. EIN 73-1446405 NONE | Legal; Direct payment from the plan Service code 29 | — | $24K |
| CHANGE HEALTHCARE SOLUTIONS NONE | Direct payment from the plan; Claims processing Service code 12 | 3055 LEBANON PIKE NASHVILLE, TN 37214 | $21K |
| DEPARTMENT OF TREASURY NONE | Direct payment from the plan; Other services Service code 49 | 1500 PENNSYLVANIA AVENUE, NW WASHINGTON, DC 20220 | $19K |
| ROBEIN, URANN, SPENCER, ET AL. EIN 73-0999672 NONE | Legal; Direct payment from the plan Service code 29 | — | $18K |
| INTERNATIONAL FOUNDATION NONE | Direct payment from the plan; Other fees Service code 50 | 18700 W BLUEMOUND RD BROOKFIELD, WI 53045 | $13K |
| CNA INSURANCE NONE | Other services; Direct payment from the plan Service code 49 | 333 S. WABASH AVENUE CHICAGO, IL 60604 | $12K |
| GOLDSTEIN GRAGEL LLC EIN 20-2565263 LEGAL | Legal; Direct payment from the plan Service code 29 | — | $12K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $10K |
| NICK HONDROS NONE | Direct payment from the plan; Other fees Service code 50 | 9810 E 83RD PL TULSA, OK 74133 | $10K |
| FEDERAL INSURANCE COMPANY EIN 13-1963496 NONE | Direct payment from the plan; Other services Service code 49 | — | $8K |
| THE ROWLAND GROUP LLC NONE | Direct payment from the plan; Other fees Service code 50 | 3851 SOUTH 103RD E. AVE TULSA, OK 74146 | $6K |
| PITNEY BOWES GLOBAL NONE | Other fees; Direct payment from the plan Service code 50 | PO BOX 223648 PITTSBURGH, PA 152502648 | $6K |
| LEWIS BRISBOIS BISGAARD & SMITH LEGAL | Legal; Direct payment from the plan Service code 29 | 633 W FIFTH ST, STE 4000 LOS ANGELES, CA 90071 | $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 | 3,493 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 774 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,267 | 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.