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 |
|---|---|---|---|
| NOITU RELATED LABOR ORG | Other services; Direct payment from the plan Service code 49 | 148-06 HILLSIDE AVENUE JAMAICA, NY 11435 | $848K |
| EMPIRE HEALTHCHOICE ASSURANCE INC EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue; Claims processing Service code 12 | — | $811K |
| BASYS, INC. EIN 52-1796473 NONE | Consulting (general); Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $376K |
| FARLEY KAMHI EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $262K |
| ANDRE WILLIAMS EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $249K |
| DAVID LIEBERMAN EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $231K |
| JAEMIN KWAK EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $172K |
| ELIZABETH FORTE EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $170K |
| VIRENDRA SHANKAR EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $164K |
| MARIELA RUSSELL-GORE EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $164K |
| WAYNE SMITH EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $152K |
| CVS NONE | Claims processing Service code 12 | 2211 SANDERS RD NORTHBROOK, IL 60062 | $146K |
| ALEXIS MICHELMAN EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $142K |
| STEPHANIE SARANITI EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $135K |
| LINDA SCARSELLA EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $134K |
| AMPARO ZOUROS EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $123K |
| ROSALIE HENRY EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $121K |
| UCS HOLDINGS, INC. EIN 81-5149270 NONE | Consulting fees Service code 70 | — | $119K |
| KAREEN MATTADEEN-HALL EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $117K |
| CHANNA JAYATILAKA EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $115K |
| AKIM WILLIAMS EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $109K |
| JOSEPH HAWLADER EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $108K |
| VELEZWENI MORRIS EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $108K |
| IVAN NIEVES EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $107K |
| LANGISTIC NETWORKS EIN 11-3594616 NONE | Other services; Direct payment from the plan; Consulting fees Service code 49 | — | $104K |
| JOSE COLLADO EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $102K |
| DAISY PEREZ EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $99K |
| ROOPKUMAR LACHMAN EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $95K |
| RAYMOND YOUNG EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $93K |
| LILLIAN OLIVO EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| SANDRA MONAHAN EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| WCM INVESTMENT MANAGEMENT, LLC EIN 95-3046237 NONE | Investment management Service code 28 | 281 BROOKS STREET LAGUNA BEACH, CA 92651 | $89K |
| DULCE URENA EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $87K |
| NANCY TARNATE EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| CYNOMYS INC. EIN 82-2668930 NONE | Actuarial Service code 11 | — | $84K |
| TANIA GUTIERREZ EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| NADAV SEGAL EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| JODI CIOFFI EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| VALERIE BERMUDEZ EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
| KIM NGUYEN EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $80K |
| JACQUELINE LUMSDEN-GRAHAM EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| ANA SOLORZANO EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| GOULD, KOBRICK & SCHLAPP EIN 11-3082707 NONE | Accounting (including auditing) Service code 10 | — | $75K |
| EDITH PAULINO EIN 11-1740492 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| GINAMARIE BAKATSIAS EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| KATRINA GRAHAM EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| YUZAHARA RIVADENEIRA EIN 11-1740492 NONE | Direct payment from the plan Service code 50 | — | $71K |
| HILDA COLL-VALENTINE EIN 11-1740492 NONE | Direct payment from the plan Service code 50 | — | $71K |
| WANDALID LEACH EIN 11-1740492 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $70K |
| RAFAEL DIAZ EIN 11-1740492 NONE | Direct payment from the plan Service code 50 | — | $70K |
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 | 3,583 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,613 | 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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.