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 |
|---|---|---|---|
| EMPLOYEE E EIN 06-0978828 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $379K |
| EMPLOYEE D EIN 06-0978828 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $227K |
| EMPLOYEE B EIN 06-0978828 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $158K |
| EMPLOYEE C EIN 06-0978828 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $125K |
| EMPLOYEE A EIN 06-0978828 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $120K |
| EMPLOYEE F EIN 06-0978828 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $93K |
| GRAFSTEIN & ARCARO LLC EIN 46-1581772 NONE | Legal; Direct payment from the plan Service code 29 | — | $73K |
| ROBERT M. CHEVERIE & ASSOCIATES PC EIN 06-1335139 NONE | Legal; Direct payment from the plan Service code 29 | — | $14K |
| STACEY BRAUN ASSOCIATES EIN 13-2889432 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $12K |
| T.M. BYXBEE COMPANY EIN 06-1386456 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $11K |
| LAW OFFICE OF NORMA PIERCE AREL EIN 22-3913084 NONE | Legal; Direct payment from the plan Service code 29 | — | $8K |
| CITIZENS BANK EIN 20-2635739 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $6K |
| BALSKUS & JOHNSTON EIN 06-1619838 NONE | Legal; Direct payment from the plan Service code 29 | — | $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 | 3,096 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,096 | 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.