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 | — | $7.4M |
| PINE LAKE DEVELOPMENT CORP EIN 14-1776863 NONE | Other services; Direct payment from the plan Service code 49 | — | $806K |
| ALLIANT INSURANCE SERVICES EIN 33-0785439 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $138K |
| MANAN LLC EIN 26-4522132 NONE | Other services; Direct payment from the plan Service code 49 | — | $68K |
| STANDISH MELLON ASSET MANAGEMENT CO EIN 25-1890416 NONE | Direct payment from the plan; Investment management Service code 28 | — | $61K |
| JEFFREY T. BUTLER P.E., P.C. EIN 20-1800746 NONE | Other services; Direct payment from the plan Service code 49 | — | $20K |
| 25 PARK PLACE LLC EIN 26-0726593 NONE | Other services; Direct payment from the plan Service code 49 | — | $20K |
| ROBERT AYELLO NONE | Consulting (general); Direct payment from the plan Service code 16 | 158-11 HARRY VAN ARSDALE JR. AVENUE FLUSHING, NY 11365 | $16K |
| RSM US LLP EIN 42-0714325 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $13K |
| DEUTSCHE BANK EIN 13-6065488 NONE | Custodial (other than securities); Direct payment from the plan Service code 18 | — | $13K |
| FDS ART WORLD EIN 11-2422575 NONE | Direct payment from the plan; Other services Service code 49 | — | $12K |
| JAUQUET & CO, INC. EIN 11-3347831 NONE | Valuation (appraisals, etc.); Direct payment from the plan Service code 34 | — | $12K |
| AKRF INC EIN 13-5331530 NONE | Other services; Direct payment from the plan Service code 49 | — | $10K |
| LIBERTY SURPLUS INSURANCE CO EIN 04-3390891 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $5K |
| STATE STREET BANK & TRUST EIN 04-1867445 NONE | Direct payment from the plan; Investment management; 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 | 24,548 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8,637 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 33,185 | 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.