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 |
|---|---|---|---|
| CIGNA EIN 06-0300070 | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 13045 TESSON FERRY ROAD ST. LOUIS, MO 75284 | $1.0M |
| THE SUNDT COMPANIES, INC. EIN 86-0923877 | Plan Administrator Service code 14 | 2015 W. RIVER ROAD, SUITE 101 TUCSON, AZ 85704 | $592K |
| SNELL & WILMER EIN 86-0089731 | Legal Service code 29 | ONE ARIZONA CENTER 400 E. VAN BUREN STE 1900 PHOENIX, AZ 85004 | $71K |
| SECOVA EIN 33-0954754 | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 5000 BIRCH STREET NEWPORT BEACH, CA 92660 | $71K |
| MAYER HOFFMAN MCCANN, P.C. EIN 43-1947695 | Accounting (including auditing) Service code 10 | 4722 NORTH 24TH STREET SUITE 300 PHOENIX, AZ 85016 | $21K |
| WELLS FARGO BANK, N.A. EIN 94-1347393 | Trustee (bank, trust company, or similar financial institution) Service code 21 | 707 WILSHIRE BLVD LOS ANGELES, CA 90017 | $12K |
| MHN EIN 95-4146179 | Other services Service code 49 | PO BOX 9088 SAN RAFAEL, CA 94912 | $9K |
| BASIC EIN 38-2883561 | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | PO BOX 775339 CHICAGO, IL 60677 | $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 | 1,693 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,693 | 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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.