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 |
|---|---|---|---|
| LOCAL 1102 RETIREMENT TRUST EIN 13-1847329 AFFILIATED FUND | Other services Service code 49 | — | $759K |
| LOCAL 1102 RWDSU EIN 13-1215130 AFFILIATED LOCAL UNION | Other services Service code 49 | — | $614K |
| MAGNACARE EIN 11-3410766 NONE | Claims processing Service code 12 | — | $197K |
| HUDSON CANYON INVESTMENT COUNSLERS EIN 22-3807432 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $161K |
| DD SERVICES INC EIN 11-2705347 NONE | Claims processing Service code 12 | — | $123K |
| ROTHMAN, ROCCO, LARUFFA, LLP EIN 47-5401457 NONE | Legal Service code 29 | — | $91K |
| LSV ASSET MANAGEMENT EIN 23-2772200 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $59K |
| STATE STREET BANK EIN 04-1867445 NONE | Custodial (securities); Other fees; Investment management Service code 19 | — | $53K |
| THOMPSON, SEIGEL & WALMSLEY LLC EIN 54-0854396 NONE | Soft dollars commissions; Investment management fees paid directly by plan; Investment management Service code 28 | — | $45K |
| ZELIS CLAIMS INTEGRITY, INC EIN 86-1040704 NONE | Consulting (general) Service code 16 | — | $39K |
| C.S. MCKEE EIN 25-1900687 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $34K |
| BERDON LLP EIN 13-0485070 NONE | Accounting (including auditing) Service code 10 | — | $33K |
| SUMMIT ACTUARIAL SERVICE LLC EIN 20-3838633 NONE | Actuarial Service code 11 | — | $24K |
| DAHAB ASSOCIATES EIN 11-2783874 NONE | Investment advisory (plan) Service code 27 | — | $20K |
| OPTUM HEALTHCARE SOLUTIONS, LLC EIN 41-1591944 NONE | Consulting (general) Service code 16 | — | $20K |
| DR. DEVITO, MD EIN 11-2991823 NONE | Consulting (general) Service code 16 | — | $11K |
| QUE GRAPHICS & COMMUNICATIONS EIN 46-0995403 NONE | Copying and duplicating Service code 36 | — | $11K |
| INNOVATIVE SOFTWARE SOLUTIONS INC EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $7K |
| ARCHER BYINGTON GLENNON & LEVINE EIN 26-0873462 NONE | Legal Service code 29 | — | $7K |
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 | 4,551 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 4,558 | 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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.