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 |
|---|---|---|---|
| EMPIRE HEALTH CHOICE EIN 23-7391136 NONE | Float revenue; Other services; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $881K |
| DICKINSON GROUP LLC EIN 20-1241472 NONE | Actuarial; Claims processing Service code 11 | — | $673K |
| DJ O'GRADY CONSULTANTS LTD EIN 13-3606747 NONE | Consulting (general); Claims processing Service code 12 | — | $211K |
| PROSKAUER ROSE LLP EIN 13-1840454 NONE | Legal Service code 29 | — | $171K |
| GLEN CAMISA EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $167K |
| INETICO INC. EIN 20-0457663 NONE | Other services Service code 49 | — | $134K |
| LABOR FIRST EIN 06-1750191 NONE | Insurance services; Other services Service code 23 | — | $123K |
| SELE-DENT, INC. EIN 11-3310187 NONE | Claims processing Service code 12 | — | $121K |
| JENNIFER BLAKE EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $116K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $102K |
| DEBRA FRAZIER EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $101K |
| MORGAN STANLEY SMITH BARNEY EIN 26-4310632 NONE | Investment management; Direct payment from the plan; Named fiduciary; Investment advisory (plan); Securities brokerage Service code 27 | — | $94K |
| STACEY NEWMAN EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $91K |
| ROBERT KATUNA EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $75K |
| TERI BRAUNER EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $73K |
| ANGELICA DARBY EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $72K |
| BARNES, IACCARINO & SHEPHERD, LLP EIN 26-3858697 NONE | Legal Service code 29 | — | $67K |
| LYNETTE BROWN EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $60K |
| ANA URRUTIA EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $55K |
| JODI HOLZKNECHT EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $55K |
| LORI SHAPIRO EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $49K |
| ELIZABETH MEDRANO-GOMEZ EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $48K |
| RICHIE KNICE EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $45K |
| VALUE OPTIONS, INC EIN 54-1414194 NONE | Insurance services Service code 23 | — | $38K |
| FLEXIBLE BUSINESS SYSTEMS EIN 11-2772357 NONE | Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $38K |
| CHRISTINA OVERTON EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $38K |
| KIESHAWNA FRAZIER EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $32K |
| WINSTON SUPPORT SERVICES LLC EIN 80-0004314 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $27K |
| SENECA CONSULTING GROUP EIN 11-3422419 NONE | Consulting (general) Service code 16 | — | $25K |
| SPECIALIZED PHARMACY SOLUTIONS EIN 86-1061619 NONE | Consulting (general); Other services Service code 16 | — | $25K |
| PROFESSIONAL EVALUATION MEDICAL GR EIN 11-3045787 NONE | Other services Service code 49 | — | $23K |
| BROADREACH MEDICAL RESOURCES, INC. EIN 02-0640082 NONE | Insurance services; Claims processing; Plan Administrator Service code 12 | — | $20K |
| GD&E COMPUTERS EIN 11-3369139 NONE | Consulting (general) Service code 16 | — | $16K |
| STEINBERG, STECKLER & PICCIURO EIN 13-2665700 NONE | Accounting (including auditing) Service code 10 | — | $15K |
| CAPITAL ONE BANK EIN 72-0210640 NONE | Distribution (12b-1) fees; Custodial (securities) Service code 19 | — | $14K |
| JEFFREY DUBIN P.C. EIN 45-4939702 NONE | Legal Service code 29 | — | $11K |
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 | 3,244 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 778 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,022 | 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.