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 |
|---|---|---|---|
| VIVERAE EIN 26-4218002 NONE | Direct payment from the plan; Other services Service code 49 | — | $1.4M |
| CIGNA BEHAVORIAL HEALTH EIN 41-1648670 NONE | Other services; Direct payment from the plan Service code 49 | — | $731K |
| NORTH AMERICAN CORPORATION EIN 36-4369474 NONE | Direct payment from the plan; Other services Service code 49 | — | $321K |
| RETHINK AUTISM, INC. EIN 26-1746074 NONE | Direct payment from the plan; Other services Service code 49 | — | $78K |
| TICKETS AT WORK- PLUM BENEFITS LLC EIN 26-1746074 NONE | Other services; Direct payment from the plan Service code 49 | — | $57K |
| AETNA EIN 06-6033492 NONE | Direct payment from the plan; Other services Service code 49 | — | $51K |
| HEALTH FITNESS CORPORATION EIN 41-1580506 NONE | Other services; Direct payment from the plan Service code 49 | — | $40K |
| CIGNA EAP EIN 41-1648670 NONE | Other services; Direct payment from the plan Service code 49 | — | $21K |
| ALERE WELLBEING INC EIN 20-0231080 NONE | Direct payment from the plan; Other services Service code 49 | — | $19K |
| BAKER TILLY VIRCHOW KRAUSE, LLP EIN 39-0859910 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $18K |
| WALGREENS EIN 36-1924025 NONE | Other services; Direct payment from the plan Service code 49 | — | $15K |
| MINUTE CLINIC EIN 41-1952112 NONE | Other services; Direct payment from the plan Service code 49 | — | $11K |
| AON HEWITT EIN 22-2232264 NONE | Other services; Direct payment from the plan Service code 49 | — | $11K |
| PNC BANK EIN 25-1211909 NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $10K |
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 | 30,113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 181 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 30,294 | 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.