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 |
|---|---|---|---|
| ALIGHT EIN 36-2235791 RECORD KEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Other fees Service code 15 | — | $1.7M |
| STATE STREET GLOBAL ADVISERS EIN 81-4017137 INVESTMENT MANAGEMENT | Investment management fees paid directly by plan; Direct payment from the plan Service code 50 | — | $571K |
| HANLON BROWN DESIGN, INC. EIN 93-1010992 COPYING & DUPLICATING | Direct payment from the plan; Copying and duplicating Service code 36 | — | $109K |
| STATE STREET BANK AND TRUST COMPANY EIN 04-1867445 TRUSTEE | Trustee (directed); Direct payment from the plan Service code 25 | — | $96K |
| ERNST & YOUNG EIN 34-6565596 ACCOUNTING INCD AUDITING | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $89K |
| MERCER EIN 34-2015463 ACTUARY | Actuarial; Direct payment from the plan Service code 11 | — | $65K |
| DELOITTE TAX LLP EIN 86-1065772 OTHER SERVICES | Other fees; Direct payment from the plan Service code 50 | — | $58K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 OTHER FEES | Direct payment from the plan; Claims processing Service code 12 | — | $47K |
| CLIFTLARSONALLEN LLP EIN 41-0746749 OTHER SERVICES | Direct payment from the plan; Other fees Service code 50 | — | $30K |
| AON INVESTMENTS USA INC. EIN 36-3109431 NONE | Consulting fees; Direct payment from the plan Service code 50 | — | $25K |
| CIGNA EIN 59-1031071 CLAIMS PROCESSOR | Contract Administrator; Direct payment from the plan; Other services; Participant communication; Non-monetary compensation; Claims processing; Named fiduciary; Float revenue; Trustee (bank, trust company, or similar financial institution) Service code 12 | — | $0 |
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 | 5,145 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4,795 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,940 | 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.