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; Contract Administrator Service code 12 | — | $2.2M |
| A&S FINANCIAL SERVICES LLC EIN 27-4188863 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $239K |
| PITNEY BOWES NONE | Direct payment from the plan; Other fees Service code 50 | PO BOX 223648 PITTSBURGH, PA 152502648 | $160K |
| DENTAL NETWORK OF AMERICA EIN 36-3339483 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $111K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $110K |
| RENEE VAUSE EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $105K |
| KIMBERLY BRASIOLA EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $103K |
| EXCEL CARE EIN 36-3668948 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $102K |
| JON BALTZELL EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $93K |
| THE SEGAL COMPANY EIN 13-2619259 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $71K |
| MICHELLE LANDTROOP EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $58K |
| JO FORD-STONE EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $54K |
| COX COMMUNICATIONS - TULSA NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 248876 OKLAHOMA CITY, OK 731248876 | $54K |
| CHAD S WILLIAMS EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $53K |
| BONNIE ROBERSON EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $51K |
| BROOKE STEPHENS EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $48K |
| DENNIS HUGGINS EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $47K |
| LISA RAIBURN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $47K |
| CANDICE GRAHAM EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $46K |
| AMBER M TROYER EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $42K |
| JEFF PARKS EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $41K |
| TONI S GRANT EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $40K |
| LESLIE OTT EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $38K |
| SAMANTHA GOFF EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $35K |
| PATTI REIF EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | PO BOX 470950 TULSA, OK 741470950 | $29K |
| RUBINBROWN LLP EIN 43-0765316 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $27K |
| SEGAL ROGERSCASEY EIN 13-2646110 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $25K |
| CNA INSURANCE NONE | Insurance services; Direct payment from the plan Service code 23 | 3055 LEBANON PIKE NASHVILLE, TN 37214 | $23K |
| ROBEIN, URANN, SPENCER, ET AL EIN 73-0999672 NONE | Legal; Direct payment from the plan Service code 29 | — | $21K |
| CHANGE HEALTHCARE SOLUTIONS, LLC NONE | Direct payment from the plan; Claims processing Service code 12 | 3055 LEBANON PIKE NASHVILLE, TN 37214 | $20K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $15K |
| PARKER + LYNCH EIN 59-3482208 NONE | Direct payment from the plan; Other services Service code 49 | — | $14K |
| AT&T MOBILITY NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 6463 CAROL STREAM, IL 601976463 | $13K |
| CVS CAREMARK EIN 75-2882129 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $13K |
| CHUBB NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | 82 HOPMEADOW STREET SIMSBURY, CT 060707683 | $12K |
| SEGAL SELECT INSURANCE EIN 46-0619194 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $11K |
| MONAGHAN & ASSOCIATES EIN 73-1462892 NONE | Legal; Direct payment from the plan Service code 29 | — | $9K |
| DATAMATION IMAGING SERVICES EIN 36-4303011 NONE | Other services; Direct payment from the plan Service code 49 | — | $7K |
| MADDIN HAUSER ROTH & HELLER PC EIN 38-3024220 NONE | Legal; Direct payment from the plan Service code 29 | — | $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 | 4,117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 838 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,955 | 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.