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 B EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $110K |
| EMPLOYEE L EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| EMPLOYEE H EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| EMPLOYEE F EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| EMPLOYEE A EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
| EMPLOYEE D EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $67K |
| ICARE MANAGEMENT LLC EIN 91-2089152 NONE | Direct payment from the plan; Other services Service code 49 | — | $45K |
| JESSICA ESPINOZA PIERRE NONE | Consulting (general); Direct payment from the plan; Consulting fees Service code 16 | 5 CAPITOL RD. , APT. 2 MILFORD, MA 01757 | $40K |
| EMPLOYEE G EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $37K |
| EMPLOYEE I EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $30K |
| HARTY PRESS EIN 06-0768090 NONE | Other services; Direct payment from the plan Service code 49 | — | $29K |
| EMPLOYEE K EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $26K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $24K |
| GEEKS FOR GOOD EAST ,LLC NONE | Consulting fees; Consulting (general); Direct payment from the plan Service code 16 | 71 NAUBUC AVENUE GLASTONBURY, CT 06033 | $12K |
| LAW OFFICE OF JOHN M CREANE EIN 06-0941734 NONE | Legal; Direct payment from the plan Service code 29 | — | $10K |
| DRIVE NONE | Consulting (general); Direct payment from the plan Service code 16 | 1913 ATLANTIC AVE., SUITE 115 MANASQUAN, NJ 08736 | $7K |
| CODE ONE TRAINING SOLUTIONS, LLC EIN 20-8471227 NONE | Direct payment from the plan; Other fees Service code 50 | — | $7K |
| HEALTH 360, INC. NONE | Other fees; Direct payment from the plan Service code 50 | 83 PROSPECT STREET WATERBURY, CT 06702 | $7K |
| POSITIVE APPROACH, LLC EIN 26-1611659 NONE | Other fees; Direct payment from the plan Service code 50 | — | $6K |
| H-CAP EDUCATION ASSOCIATION EIN 46-4604754 NONE | Direct payment from the plan; Other services Service code 49 | — | $6K |
| LIVEWELL EIN 22-3068632 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $5K |
| ICARE MENTAL HEALTH FIRST AID EIN 91-2089152 NONE | Direct payment from the plan; Other fees Service code 50 | — | $5K |
| INSTITUTE OF LIVING EIN 06-0646668 NONE | Direct payment from the plan; Other services Service code 49 | — | $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 | 4,684 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,684 | 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.