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 |
|---|---|---|---|
| JOINT INDUSTRY BOARD EIN 13-0891035 NONE | Plan Administrator; Direct payment from the plan Service code 14 | — | $6.8M |
| PINE LAKE DEVELOPMENT CORP EIN 14-1776863 NONE | Direct payment from the plan; Other services Service code 49 | — | $811K |
| ALLIANT INSURANCE SERVICES EIN 33-0785439 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $120K |
| MANAN LLC EIN 26-4522132 NONE | Direct payment from the plan; Other services Service code 49 | — | $80K |
| STANDISH MELLON ASSET MANAGEMENT CO EIN 25-1890416 NONE | Direct payment from the plan; Investment management Service code 28 | — | $61K |
| 25 PARK PLACE LLC EIN 26-0726593 NONE | Other services; Direct payment from the plan Service code 49 | — | $53K |
| POSTMASTER GENERAL NONE | Other services; Direct payment from the plan Service code 49 | UNION ST STE A FLUSHING, NY 113549997 | $32K |
| H&H GRAPHIC PRINTING COMMUNICATIONS EIN 27-0771521 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $27K |
| B&H PHOTO VIDEO EIN 13-2768071 NONE | Other services; Direct payment from the plan Service code 49 | — | $27K |
| MARCUS & POLLACK LLP EIN 20-2249613 NONE | Legal; Direct payment from the plan Service code 29 | — | $23K |
| DEUTSCHE BANK EIN 13-6065488 NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $20K |
| TWOMEY, LATHAM, SHEA, KELLY, DUBIN EIN 11-2687291 NONE | Legal; Direct payment from the plan Service code 29 | — | $16K |
| NORTRIDGE SOFTWARE LLC EIN 57-1230448 NONE | Other services; Direct payment from the plan Service code 49 | — | $16K |
| J J ROSENBERG ELECTRIC CONTRACTORS EIN 11-2121826 NONE | Other services; Direct payment from the plan Service code 49 | — | $15K |
| RSM US LLP EIN 42-0714325 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $13K |
| JEFFREY T. BUTLER P.E., P.C. EIN 20-1800746 NONE | Other services; Direct payment from the plan Service code 49 | — | $8K |
| F & J BAGELS INC EIN 11-2665580 NONE | Other services; Direct payment from the plan Service code 49 | — | $8K |
| LIBERTY SURPLUS INSURANCE CO EIN 04-3390891 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $6K |
| MILROSE CONSULTANTS EIN 11-3039923 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $5K |
| STATE STREET EIN 04-1867445 NONE | Investment management; Direct payment from the plan; Product termination fees (surrender charges, etc.) Service code 28 | — | $3K |
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 | 25,250 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 25,250 | 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.