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 |
|---|---|---|---|
| ANTHEM BLUE CROSS BLUE SHIELD EIN 87-0747736 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $3.5M |
| OPTUM RX EIN 33-0441200 NONE | Direct payment from the plan; Other services Service code 49 | — | $1.5M |
| EGAN, RICHARD B EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $343K |
| BARNETT, GREGORY L EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $257K |
| POTTS, KEVIN J EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $256K |
| DUMAC EIN 84-1370319 NONE | Direct payment from the plan; Other services Service code 49 | — | $210K |
| JOHNSON, BEN EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $186K |
| HUGHES, CURT EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $173K |
| PORTER, BRADLEY J EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $173K |
| NEWMAN, CURTIS C EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $155K |
| PDX, INC. EIN 75-2103975 NONE | Other services; Direct payment from the plan Service code 49 | — | $153K |
| ANTHONY, JENNIFER EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $148K |
| HATCH, MICHAEL T EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $148K |
| FARNSWORTH, CARRIELYN J EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $142K |
| STEELE, CHRISTOPHER EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $141K |
| TEUSCHER, BRADY G EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $140K |
| WIDDISON, RONNIE W EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $140K |
| Y&L CONSULTING, INC. EIN 36-4248787 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $140K |
| KREIS, KARA EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $133K |
| ADAMS, SPENCER L EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $133K |
| VANTIV EIN 26-4532998 NONE | Direct payment from the plan; Other services Service code 49 | — | $131K |
| KITTERMAN, RICHARD EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $125K |
| VALCOM SALT LAKE CITY, LC EIN 87-0574827 NONE | Other services; Direct payment from the plan Service code 49 | — | $124K |
| STEVENS, JOHN P EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $117K |
| BARKER, KIRK EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $112K |
| DONOHUE, RICHARD M EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $109K |
| PATTEN ENTERPRISES, INC EIN 87-0560099 NONE | Other services; Direct payment from the plan Service code 49 | — | $106K |
| SMART, JULIE EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $101K |
| BIRKETT, JOHANNA EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $101K |
| PUFF, ANDREA EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| ARMSTRONG, DARIN C EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| GILBERT, D MICHELE EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| HENDERSON, MICAH EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $95K |
| HAYES, TONYA L EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $92K |
| COMPUTECH EIN 87-0557821 NONE | Other services; Direct payment from the plan Service code 49 | — | $85K |
| ALAN SEIDEN CONSULTING, LLC EIN 45-5506003 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $84K |
| PETERSON, PATRICIA EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| BARBARA A. MARTZ NONE | Other services; Direct payment from the plan Service code 49 | 98526 CAMELLIA DR BROOKINGS, OR 97415 | $82K |
| MCGUIRE, KELLY EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $80K |
| WARDROPE, ALYSON R EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $80K |
| BRAINTRACE, INC EIN 81-2552926 NONE | Direct payment from the plan; Other services Service code 49 | — | $80K |
| WHITESIDES, TYSON W EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| HANKS, WADE K EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| BONSTEEL, RAY EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| HUBBART, JENNY EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| WOOD, JEFFREY D EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $73K |
| FACER, SARAH EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $71K |
| AHIO, ANNA EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| REED, MINDI EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $70K |
| RUNDLE, CHRISTINE M EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $70K |
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 | 13,220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12,876 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 26,096 | 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.