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 |
|---|---|---|---|
| CCPOA BENFIT TRUST FUND EIN 94-6459649 PARTY IN INTEREST | Direct payment from the plan; Contract Administrator Service code 13 | — | $1.5M |
| LEGAL SERVICE BUREAU INC. EIN 33-0817988 NONE | Other services; Direct payment from the plan Service code 49 | — | $48K |
| TRUCKER HUSS, APC EIN 94-3216063 NONE | Legal; Direct payment from the plan Service code 29 | — | $44K |
| SELLWOOD CONSULTING LLC EIN 80-0827237 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $31K |
| THE SEGAL COMPANY (WESTERN STATES) EIN 94-1503999 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $29K |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $13K |
| CORNERSTONE STAFFING SOLUTIONS, INC NONE | Direct payment from the plan; Other services Service code 49 | 5820 STONERIDGE MALL ROAD PLEASANTON, CA 94588 | $10K |
| DELTA PRINT GROUP, LLC EIN 84-3487156 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $8K |
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 | 8,274 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 8,274 | 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.