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 | Insurance services; Direct payment from the plan Service code 23 | — | $3.2M |
| OPTUM RX EIN 33-0441200 NONE | Direct payment from the plan; Other services Service code 49 | — | $1.4M |
| EGAN, RICHARD B EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $315K |
| BARNETT, GREGORY L EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $261K |
| POTTS, KEVIN J EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $257K |
| CHANGE HEALTHCARE EIN 20-5716594 NONE | Other services; Direct payment from the plan Service code 49 | — | $239K |
| JOHNSON, BEN EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $180K |
| PORTER, BRADLEY J EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $166K |
| HUGHES, CURT EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $165K |
| NEWMAN, CURTIS C EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $158K |
| TAYLOR, JOHN R EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $153K |
| ANTHONY, JENNIFER EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $148K |
| FARNSWORTH, CARRIELYN J EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $146K |
| STEELE, CHRISTOPHER EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $145K |
| HATCH, MICHAEL T EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $144K |
| KREIS, KARA EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $139K |
| TEUSCHER, BRADY G EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $138K |
| ADAMS, SPENCER L EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $138K |
| VANTIV EIN 26-4532998 NONE | Direct payment from the plan; Other services Service code 49 | — | $133K |
| TELLIGEN, INC. EIN 42-0992483 NONE | Direct payment from the plan; Other services Service code 49 | — | $129K |
| KITTERMAN, RICHARD EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| BARKER, KIRK T EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $115K |
| PARKER, VON 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 | — | $111K |
| WHITLEY, JACOB EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $107K |
| STEVENS, JOHN P EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $107K |
| BIRKETT, JOHANNA EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $107K |
| SMART, JULIE EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $101K |
| HENDERSON, MICAH EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $97K |
| PUFF, ANDREA EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $95K |
| ARMSTRONG, DARIN C EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $95K |
| GILBERT, D MICHELE EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| DUMAC EIN 84-1370319 NONE | Other services; Direct payment from the plan Service code 49 | — | $92K |
| HAYES, TONYA L EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| WIDDISON, RONNIE W EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| PATTEN ENTERPRISES, INC. EIN 87-0560099 NONE | Other services; Direct payment from the plan Service code 49 | — | $87K |
| WHITESIDES, TYSON EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| MCGUIRE, KELLY EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| WOOD, JEFFREY D EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
| WARDROPE, ALYSON R EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
| HANKS, WADE K EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $78K |
| TIMPANOGOS PHARMACY CONSULTANT EIN 20-4591107 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $78K |
| BONSTEEL, RAY EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| REED, MINDI EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
| AHIO, ANNA EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
| HEALTHLINX, LLC EIN 87-0660214 NONE | Direct payment from the plan; Other services Service code 49 | — | $75K |
| FACER, SARAH EIN 87-0427760 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| HUBBART, JENNY EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $72K |
| TODD, BOBBIE JO EIN 87-0427760 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $72K |
| HALES, LISA 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 | 12,619 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12,558 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 25,177 | 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.