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 |
|---|---|---|---|
| MARY P. O'MALLEY EIN 04-6357603 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $162K |
| JOHN A. RICE, JR. EIN 04-6357603 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $139K |
| CESARE PIETRANGELO, JR. EIN 04-6357603 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $132K |
| RICHARD A. PETISCE EIN 04-6357603 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| MICHAEL J. RILEY EIN 04-6357603 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $111K |
| ROSEMARIE VESPA EIN 04-6357603 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $93K |
| ROBERT M. CASSESSO, JR. EIN 04-6357603 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| KELLY M. WALSH EIN 04-6357603 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| ROBERT M. FUSTER, ATTORNEY AT LAW EIN 27-1784148 NONE | Direct payment from the plan Service code 50 | — | $54K |
| LAW OFFICES OF JENNIFER FEARNLEY EIN 04-3341614 NONE | Legal; Direct payment from the plan Service code 29 | — | $50K |
| MONICA ACOSTA PROIA EIN 04-6357603 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| TAMMI L. CAMPBELL O'BRIEN EIN 04-6357603 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| MARIEN & HODGE, P.C. EIN 04-3399728 NONE | Legal; Direct payment from the plan Service code 29 | — | $28K |
| LAW OFFICES OF PATRICK J. DEVINE,PC EIN 02-0448499 NONE | Legal; Direct payment from the plan Service code 29 | — | $28K |
| DARREN F. CORRENTE COUNSELOR AT LAW EIN 06-1484539 NONE | Legal; Direct payment from the plan Service code 29 | — | $21K |
| CROWE HORWATH, LLP EIN 35-0921680 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $21K |
| AHMED EL IDRISSI DBA TECHBOWIE INC. NONE | Direct payment from the plan; Other services Service code 49 | 200 ALLENS AVE PROVIDENCE, RI 02903 | $17K |
| SNI COMPANIES EIN 27-1342559 NONE | Consulting (general); Direct payment from the plan Service code 16 | 200 W ADAMS STREET CHICAGO, IL 60606 | $13K |
| LAW OFFICES OF DAVID A. LADIZKI EIN 04-2803435 NONE | Legal; Direct payment from the plan Service code 29 | — | $13K |
| MEKETA INVESTMENT GROUP, INC. EIN 04-2659023 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $13K |
| FIRST INDEMNITY INSURANCE AGENCY EIN 04-3171344 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $12K |
| MERILL, HYDE, FORTIER, & YOUNEY, PA EIN 01-0499913 NONE | Legal; Direct payment from the plan Service code 29 | — | $8K |
| LAW OFFICE OF JOHN J.A. SCHREPFER EIN 02-0451214 NONE | Legal; Direct payment from the plan Service code 29 | 147 RUSSELL STREET MANCHESTER, NH 03104 | $8K |
| THE MASTROGIACOMO LAW OFFICES, P.A. EIN 46-2799236 NONE | Legal; Direct payment from the plan Service code 29 | 134 MAIN STREET LEWISTON, ME 04240 | $6K |
| THOMAS J. CHIROKAS, ATTORNEY EIN 26-3744442 NONE | Legal; Direct payment from the plan Service code 29 | 969 MAIN STREET WALPOLE, MA 02081 | $6K |
| LAW OFFICES OF CHERIE L. MCKENNA EIN 81-4062935 NONE | Legal; Direct payment from the plan Service code 29 | 75 MARKET ST 400 SPRINGIELD, MA 01103 | $6K |
| LAW OFFICE OF DAVID E. HOYT EIN 04-3368538 NONE | Legal; Direct payment from the plan Service code 29 | — | $5K |
| LAW OFFICES OF CORBY A. GARY NONE | Legal; Direct payment from the plan Service code 29 | 107 EASTERN AVE ST JOHNSBURY, VT 05819 | $5K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9,450 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 9,450 | 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.