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 | — | $109K |
| EMPLOYEE L EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $94K |
| EMPLOYEE C EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $91K |
| EMPLOYEE H EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| EMPLOYEE A EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $81K |
| EMPLOYEE F EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $80K |
| EMPLOYEE G EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $42K |
| EMPLOYEE I EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $32K |
| EMPLOYEE D EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $30K |
| EMPLOYEE K EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $29K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $25K |
| QUALIDIGM NONE | Direct payment from the plan; Other services Service code 49 | 936 SILAS DEANE HWY 1A WETHERSFIELD, CT 03109 | $22K |
| HARTY PRESS EIN 06-0768090 NONE | Other services; Direct payment from the plan Service code 49 | — | $22K |
| LS GERANTOLOGY NONE | Other services; Direct payment from the plan Service code 49 | 840 SHORE RD, 2A LONG BEACH, NY 11561 | $11K |
| GEEKS FOR GOOD EAST ,LLC NONE | Consulting fees; Consulting (general); Direct payment from the plan Service code 16 | 71 NAUBUC AVENUE GLASTONBURY, CT 06033 | $11K |
| ADVANCED CENTER FOR NURSING NONE | Other services; Direct payment from the plan Service code 49 | 169 DAVENPORT AVE. NEW HAVEN, CT 06519 | $9K |
| ALVAREZ PORTER GROUP NONE | Consulting fees; Other services; Direct payment from the plan Service code 49 | 83 IRIQUOIS RD. YONKERS, NY 10710 | $8K |
| HUSTLE, INC. NONE | Direct payment from the plan; Participant communication Service code 38 | 343 SANSOM STREET, 6TH FLOOR SAN FRANCISCO, CA 94104 | $6K |
| H-CAP EDUCATION ASSOCIATION EIN 46-4604754 NONE | Direct payment from the plan; Other services Service code 49 | — | $6K |
| LAW OFFICE OF JOHN M CREANE EIN 06-0941734 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 | 4,703 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,703 | 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.