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 | — | $908K |
| DICKINSON GROUP LLC EIN 20-1241472 NONE | Claims processing; Actuarial Service code 11 | — | $667K |
| INETICO INC. EIN 20-0457663 NONE | Other services Service code 49 | — | $151K |
| PROSKAUER ROSE LLP EIN 13-1840454 NONE | Legal Service code 29 | — | $144K |
| SELE-DENT, INC. EIN 11-3310187 NONE | Claims processing Service code 12 | — | $124K |
| LABOR FIRST EIN 06-1750191 NONE | Other services; Insurance services Service code 23 | — | $121K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $112K |
| GLEN CAMISA EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $111K |
| BEACON HEALTH OPTIONS, INC EIN 54-1414194 NONE | Insurance services Service code 23 | — | $95K |
| JENNIFER BLAKE EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $91K |
| BILL SALVATORE EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $69K |
| JODI HOLZKNECHT EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| LORI SHAPIRO EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| BARNES, IACCARINO & SHEPHERD, LLP EIN 26-3858697 NONE | Legal Service code 29 | — | $55K |
| ROBERT KATUNA EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $49K |
| ANGELICA DARBY EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| TERI BRAUNER EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| ANA URRUTIA EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $46K |
| COLLERAN, O'HARA & MILLS LLP EIN 11-2940050 NONE | Legal Service code 29 | — | $41K |
| LYNETTE BROWN EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $38K |
| STACEY NEWMAN EMPLOYEE | Employee (plan) Service code 30 | 195 MINEOLA BLVD MINEOLA, NY 11501 | $38K |
| NU CENTURY PRODUCTS LLC NONE | Other services Service code 49 | 17 MILLSTONE CT MORRISTOWN, NJ 07960 | $37K |
| PROFESSIONAL EVALUATION MEDICAL GR EIN 11-3045787 NONE | Other services Service code 49 | — | $36K |
| GREEN KEY RESOURCES NONE | Other services Service code 49 | 475 PARK AVE S NEW YORK, NY 10016 | $36K |
| FLEXIBLE BUSINESS SYSTEMS EIN 11-2772357 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 15 | — | $34K |
| ASHLEY ORMON EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| SEGAL CONSULTING NONE | Other services Service code 49 | 333 W 34TH ST NEW YORK, NY 10001 | $32K |
| DEBRA FRAZIER EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| CARLOS ANDRADE EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $31K |
| SYNTONIC SYSTEMS, INC. NONE | Other services Service code 49 | 111 JOHN STREET, SUITE 1700 NEW YORK, NY 10038 | $29K |
| REYNOLDS CONSULTING SERVICES EIN 20-1899564 NONE | Investment advisory (plan) Service code 27 | — | $29K |
| KIESHAWNA FRAZIER EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| JEFFREY S. DUBIN P.C. EIN 45-4939702 NONE | Legal Service code 29 | — | $22K |
| STEINBERG, STECKLER & PICCIURO EIN 13-2665700 NONE | Accounting (including auditing) Service code 10 | — | $19K |
| SENECA CONSULTING GROUP EIN 11-3422419 NONE | Consulting (general) Service code 16 | — | $19K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $11K |
| WINSTON SUPPORT SERVICES LLC EIN 80-0004314 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $9K |
| CAPITAL ONE, N.A. EIN 72-0210640 NONE | Distribution (12b-1) fees; Investment management fees paid directly by plan Service code 51 | — | $8K |
| PERFECT PRINTING SOLUTIONS NONE | Other services Service code 49 | 34 E MAIN ST 396 SMITHTOWN, NY 11787 | $7K |
| SIDNEY B. BOWNE & SON, LLP NONE | Other services Service code 49 | 234 E JERICHO TPKE MINEOLA, NY 11501 | $6K |
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 | 3,193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 669 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,862 | 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.