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 | — | $115K |
| EMPLOYEE G EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $97K |
| EMPLOYEE H EIN 06-1163056 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| EMPLOYEE L EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $88K |
| EMPLOYEE A EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $85K |
| EMPLOYEE F EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $85K |
| EMPLOYEE C EIN 06-1163056 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| QUALIDIGM NONE | Direct payment from the plan; Other services Service code 49 | 936 SILAS DEANE HWY 1A WETHERSFIELD, CT 03109 | $38K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $25K |
| HARBOR SCHOOL OF PHLEBOTOMY NONE | Direct payment from the plan; Other fees Service code 50 | 141 CAPTAIN THOMAS BLVD WEST HAVEN, CT 06516 | $21K |
| GEEKS FOR GOOD EAST ,LLC NONE | Direct payment from the plan; Consulting fees; Consulting (general) Service code 16 | 71 NAUBUC AVENUE GLASTONBURY, CT 06033 | $18K |
| PASCOE WORKFORCE SOLUTION LLC NONE | Direct payment from the plan; Consulting (general) Service code 16 | 1680 RIVERDALE ST., WEST SPRINGFIELD, MA 01089 | $13K |
| SWIFT RIVER CONSULTING LLC NONE | Direct payment from the plan; Consulting (general) Service code 16 | 4207 SE WOODSTOCK BLVD., STE 248 PORTLAND, OR 97206 | $11K |
| UMASS MEDICAL SCHOOL NONE | Direct payment from the plan; Other fees Service code 50 | 364 PLANTATION STREET WORCESTER, MA 01605 | $9K |
| TRANSFORMATIVE LDRSP STRATEGIES NONE | Other fees; Direct payment from the plan Service code 50 | PO BOX 370552 WEST HARFORD, CT 06137 | $9K |
| UNION PRINTING NONE | Other services; Direct payment from the plan Service code 49 | 45 WESTRIDGE DRIVE WATERBURY, CT 06708 | $8K |
| H-CAP EDUCATION ASSOCIATION EIN 46-4604754 NONE | Direct payment from the plan; Other services Service code 49 | — | $6K |
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 | 4,419 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,419 | 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.