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 |
|---|---|---|---|
| HEWITT ASSOCIATES LLC EIN 36-2235791 RECORD KEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 15 | — | $1.0M |
| STATE STREET GLOBAL ADVISERS EIN 04-1867445 INVESTMENT MANAGEMENT | Investment management fees paid directly by plan; Non-monetary compensation Service code 51 | — | $427K |
| CIGNA EIN 06-0303370 CLAIMS PROCESSING | Non-monetary compensation; Named fiduciary; Participant communication; Float revenue; Direct payment from the plan; Contract Administrator; Other services; Claims processing Service code 12 | — | $173K |
| ERNST & YOUNG EIN 34-6565596 ACCOUNTING INCD AUDITING | Trustee (directed) Service code 25 | — | $88K |
| HANLON BROWN DESIGN EIN 93-1010992 COPYING & DUPLICATING | Copying and duplicating Service code 36 | — | $77K |
| STATE STREET BANK AND TRUST COMPANY EIN 04-1867445 TRUSTEE (DIRECTED) | Trustee (directed) Service code 25 | — | $67K |
| MERCER EIN 34-2015463 ACTUARY | Actuarial Service code 11 | — | $62K |
| EXPRESS SCRIPTS INC EIN 22-3461740 MANAGEMENT SERVICES | Contract Administrator; Other fees Service code 13 | — | $22K |
| DELOITTE & TOUCHE EIN 86-1065772 OTHER SERVICES | Other fees Service code 99 | — | $17K |
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. |
| Retired/separated still receiving benefits | 3,450 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6,050 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,500 | 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.