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 57-3493749 NONE | Legal; Direct payment from the plan Service code 29 | — | $301K |
| EXEMPLAR LEGAL & BENEFIT ADMIN. SVC EIN 68-0470505 NONE | Plan Administrator; Claims processing Service code 12 | — | $249K |
| LAW OFFICES OF FELLOM & SOLORIO EIN 94-3236152 NONE | Legal; Direct payment from the plan Service code 29 | — | $161K |
| LAW OFFICES OF MARCO ACOSTA NONE | Legal; Direct payment from the plan Service code 29 | 201 SPEAR ST STE 1100 SAN FRANCISCO, CA 94105 | $102K |
| THE COMMUNITY LAW OFFICE NONE | Legal; Direct payment from the plan Service code 29 | 1720 BROADWAY STE 430 OAKLAND, CA 94612 | $77K |
| NORTHWEST ADMINISTRATOS INC. EIN 91-0680697 NONE | Contract Administrator; Direct payment from the plan Service code 13 | 2323 EASTLAKE AVE E SEATTLE, WA 98102 | $72K |
| BEAN AND LLOYD LLP EIN 45-2930648 NONE | Legal; Direct payment from the plan Service code 29 | — | $44K |
| AMERICAN TRUST INSTITUTE EIN 32-0113305 NONE | Legal; Direct payment from the plan Service code 29 | — | $32K |
| RAEL LETSON EIN 94-1701048 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $23K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $20K |
| LAW OFFICE OF DAVID BUTLER, JR. EIN 94-3140357 NONE | Legal; Direct payment from the plan Service code 29 | — | $17K |
| LAW OFFICES OF NANCY M. CONWAY EIN 94-3302179 NONE | Legal; Direct payment from the plan Service code 29 | — | $15K |
| AABCO PRINTING NONE | Other services Service code 49 | 1300 GALAXY WAY STE 20 CONCORD, CA 94520 | $10K |
| MCCARTHY LAW OFFICES EIN 56-9761471 NONE | Legal; Direct payment from the plan Service code 29 | — | $8K |
| LEONARD CARDER LLP NONE | Legal; Direct payment from the plan Service code 29 | 1999 HARRISON ST STE 2700 OAKLAND, CA 94614 | $7K |
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 | 4,649 | 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) | 4,649 | 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.