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 |
|---|---|---|---|
| WANG & ASSOCIATES EIN 94-3340109 NONE | Legal; Direct payment from the plan Service code 29 | — | $447K |
| LAW OFFICES OF FELLOM & SOLORIO EIN 94-3236752 NONE | Legal; Direct payment from the plan Service code 29 | — | $349K |
| EXEMPLAR LEGAL & BENEFIT ADMIN. SVC EIN 68-0470505 NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $290K |
| MARCO ACOSTA, ESQ. EIN 55-6254894 NONE | Legal; Direct payment from the plan Service code 29 | — | $170K |
| ALEXSIS C. BEACH, ESQ. EIN 94-3216077 NONE | Legal; Direct payment from the plan Service code 29 | — | $107K |
| AMERICAN TRUST INSTITUTE EIN 32-0113305 NONE | Legal; Direct payment from the plan Service code 29 | — | $91K |
| BENESYS ADMINISTRATORS, INC. EIN 38-2383171 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $46K |
| LAW OFFICE OF DAVID BUTLER, JR. EIN 94-3140357 NONE | Legal; Direct payment from the plan Service code 29 | — | $29K |
| RAEL & LETSON EIN 94-1701048 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $26K |
| LAW OFFICES OF NADINE R. ZELTZER EIN 56-6024948 NONE | Legal; Direct payment from the plan Service code 29 | — | $26K |
| MITCHELL LAW OFFICE EIN 55-5899294 NONE | Legal; Direct payment from the plan Service code 29 | — | $21K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $16K |
| MCCARTHY LAW OFFICES EIN 56-9781471 NONE | Legal; Direct payment from the plan Service code 29 | — | $11K |
| NANCY M CONWAY & ASSOCIATES, L.P. NONE | Legal; Direct payment from the plan Service code 29 | 345 FRANKLIN ST SAN FRANCISCO, CA 94102 | $11K |
| SMARTSOURCE, LLC EIN 54-2104343 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $9K |
| GABRIELA M. LOPEZ, ESQ. EIN 46-4845203 NONE | Legal; Direct payment from the plan Service code 29 | — | $6K |
| MARSH & MCLENNAN AGENCY EIN 36-1436000 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $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 | 7,150 | 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) | 7,150 | 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."
No prospect flags tripped on this filing.