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 |
|---|---|---|---|
| W. C. EARHART CO., INC. | Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Plan Administrator Service code 14 | PO BOX 4148 PORTLAND, OR 97208 | $16K |
| PAUL C. HAYS | Legal; Direct payment from the plan Service code 29 | 9600 SW OAK STREET SUITE 240 TIGARD, OR 97223 | $8K |
| MIDDLETON & COMPANY, CPA, PC EIN 93-0809066 | Accounting (including auditing); Direct payment from the plan Service code 10 | 9725 SW BEAVERTON HILLSDALE HWY SUITE 220 BEAVERTON, OR 97005 | $2K |
| WITHUMSMITH BROWN, PC | Accounting (including auditing); Direct payment from the plan Service code 10 | PO BOX 5340 PRINCETON, NJ 08543 | $1K |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | 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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.