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 | — | $7.1M |
| ALLIANT INSURANCE SERVICES, INC. EIN 33-0785439 NONE | Direct payment from the plan; Insurance services Service code 23 | — | $207K |
| MANAN LLC EIN 26-4522132 NONE | Direct payment from the plan; Other services Service code 49 | — | $164K |
| MELLON INVESTMENT CORP EIN 25-1442864 NONE | Direct payment from the plan; Investment management Service code 28 | — | $65K |
| PINE LAKE DEVELOPMENT CORP EIN 14-1776863 NONE | Other services; Direct payment from the plan Service code 49 | — | $65K |
| TRALIANT LLC EIN 81-1261281 NONE | Other services; Direct payment from the plan Service code 49 | — | $31K |
| DAVROSE CORP NONE | Consulting (general); Direct payment from the plan Service code 16 | 25 ROCKWOOD ROAD WEST PLANDOME, NY 11030 | $28K |
| CITRIX SYSTEMS, INC. EIN 75-2275152 NONE | Other services; Direct payment from the plan Service code 49 | — | $23K |
| RSM US LLP EIN 42-0714325 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $17K |
| CARD QUEST, INC. NONE | Copying and duplicating; Direct payment from the plan Service code 36 | PO BOX 1915 ELFERS, FL 34680 | $13K |
| CON-EDISON EIN 13-5009340 NONE | Other services; Direct payment from the plan Service code 49 | — | $12K |
| LEGACY OFFICE SOLUTIONS, LLC NONE | Other services; Direct payment from the plan Service code 49 | 754 JAMAICA AVENUE BROOKLYN, NY 11208 | $11K |
| NORTRIDGE SOFTWARE LLC EIN 57-1230448 NONE | Other services; Direct payment from the plan Service code 49 | — | $9K |
| DEUTSCHE BANK EIN 13-6065488 NONE | Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $6K |
| LIBERTY MUTUAL INSURANCE NONE | Insurance services; Direct payment from the plan Service code 23 | PO BOX 85830 SAN DIEGO, CA 92186 | $5K |
| STATE STREET BANK & TRUST COMPANY EIN 04-1867445 NONE | Direct payment from the plan; Investment management; Other fees Service code 28 | — | $2K |
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 | 21,327 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7,913 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 29,240 | 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.