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 |
|---|---|---|---|
| ANDREW MONTELEONE, ESQ EIN 83-3559409 NONE | Other services Service code 49 | 70 HUDSON STREET, 3RD FLOOR HOBOKEN, NJ 07030 | $55K |
| SAMUEL GOLDSTEIN & CO., P.C. EIN 11-2478817 NONE | Accounting (including auditing) Service code 10 | 150 GREAT NECK RD. - SUITE 202 GREAT NECK, NY 11021 | $17K |
| KEVIN P. FEERICK, ESQ EIN 01-0719672 NONE | Other fees Service code 99 | 236 WEST 26TH STREET, SUITE 303 NEW YORK, NY 10001 | $15K |
| WEAVER & TIDWELL LLP EIN 75-0786316 NONE | Accounting (including auditing) Service code 10 | 12750 MERIT DR DALLAS, TX 75251 | $8K |
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 | 702 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 702 | 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.