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 |
|---|---|---|---|
| FIDELITY INV. INST. OPS. CO., INC. EIN 04-2647786 RECORDKEEPER | Participant loan processing; Recordkeeping fees; Account maintenance fees Service code 37 | — | $1.7M |
| WELLS FARGO BANK, N.A TRUST OPS EIN 95-3692822 INVESTMENT ADVISOR | Investment management Service code 28 | — | $341K |
| SYSCO CORPORATION EIN 74-1648137 PLAN ADMINISTARTOR | Plan Administrator; Legal; Accounting (including auditing) Service code 10 | — | $116K |
| MERCER INVESTMENT CONSULTING INC. EIN 13-3036745 INVESTMENT ADVISOR | Other investment fees and expenses Service code 72 | — | $35K |
| ADP, INC EIN 13-3036745 OTHER SERVICES | Other services Service code 49 | — | $9K |
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 | 39,200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 157 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9,866 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 153 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 49,376 | 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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.