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 |
|---|---|---|---|
| UBS FINANCIAL SERVICES INC. EIN 13-2638166 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | 1285 AVENUE OF THE AMERICAS NEW YORK, NY 100196028 | $116K |
| MULTIPLAN INC EIN 13-3068979 NONE | Claims processing; Direct payment from the plan Service code 12 | 115 FIFTH AVENUE NEW YORK, NY 10003 | $62K |
| GATEWAY REALTY LLC NONE | Other services; Direct payment from the plan Service code 49 | C/O EMPIRE MANAGEMENT, 347 5TH AVE NEW YORK, NY 10016 | $60K |
| THIANIA C GUZMAN EIN 13-1687014 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 363 7TH AVENUE, 17TH FLOOR NEW YORK, NY 100013904 | $48K |
| GLORIA SIMPSON EIN 13-1687014 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 363 7TH AVENUE, 17TH FLOOR NEW YORK, NY 100013904 | $47K |
| SASHA M. DELACRUZ EIN 13-1687014 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 363 7TH AVENUE, 17TH FLOOR NEW YORK, NY 100013904 | $41K |
| SUSANNE K DORIS EIN 13-1687014 TRUSTEE ADMIN | Direct payment from the plan; Consulting (general) Service code 16 | 363 7TH AVENUE, 17TH FLOOR NEW YORK, NY 100013904 | $32K |
| MSPC EIN 22-2951202 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 340 NORTH AVENUE CRANFORD, NY 07016 | $24K |
| WINMILL SOFTWARE NONE | Direct payment from the plan; Consulting (general) Service code 16 | 420 LEXINGTON AVE. 455 NEW YORK, NY 10170 | $22K |
| SEGAL COMPANY EIN 94-1503999 NONE | Actuarial; Consulting (general); Direct payment from the plan Service code 11 | — | $12K |
| GLEN M BANDES CPA EIN 22-3080908 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 19 SHERBROOKE DR LINCOLN PARK, NJ 07035 | $10K |
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 | 232 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 232 | 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.