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 | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $966K |
| DICKINSON GROUP LLC EIN 20-1241472 NONE | Actuarial; Claims processing Service code 11 | — | $657K |
| INETICO INC. EIN 20-0457663 NONE | Other services Service code 49 | — | $162K |
| BILL SALVATORE EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $135K |
| SELE-DENT, INC. EIN 11-3310187 EMPLOYEE | Claims processing Service code 12 | — | $131K |
| GLEN CAMISA EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $114K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $107K |
| BOYD WATTERSON ASSET MGMT, LLC EIN 34-1922005 NONE | Investment management Service code 28 | — | $104K |
| BEACON HEALTH OPTIONS, INC EIN 54-1414194 NONE | Insurance services Service code 23 | — | $100K |
| JENNIFER BLAKE EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $97K |
| COLLERAN, O'HARA & MILLS LLP EIN 11-2940050 NONE | Legal Service code 29 | — | $84K |
| CARLOS ANDRADE EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $71K |
| JODI HOLZKNECHT EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $67K |
| LORI SHAPIRO EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| ANGELICA DARBY EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| ROBERT KATUNA EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| ANA URRUTIA EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| TERI BRAUNER EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| LYNETTE BROWN EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $40K |
| FLEXIBLE SYSTEM EIN 11-2772357 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 15 | — | $39K |
| PROSKAUER ROSE LLP EIN 13-1840454 NONE | Legal Service code 29 | — | $35K |
| GREEN KEY RESOURCES NONE | Other services Service code 49 | 475 PARK AVE S NEW YORK, NY 10016 | $34K |
| DEBRA FRAZIER EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| PROFEESSIONAL EVALUATION MEDICAL GR EIN 11-3045787 NONE | Other services Service code 49 | — | $31K |
| JEFFREY S. DUBIN P.C. EIN 45-4939702 NONE | Legal Service code 29 | — | $30K |
| KIESHAWNA FRAZIER EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $28K |
| REYNOLDS CONSULTING SERVICES EIN 20-1899564 NONE | Investment advisory (plan) Service code 27 | — | $27K |
| JOAN AEBLY EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| CHRISTINA OVERTON EIN 13-5530847 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| SYNTONIC SYSTEM, INC. NONE | Other services Service code 49 | 111 JOHN STREET, SUITE 1700 NEW YORK, NY 10038 | $23K |
| AMALGAMATED BANK EIN 13-4920330 NONE | Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $12K |
| PERFECT PRINTING SOLUTIONS NONE | Other services Service code 49 | 34 E. MAIN ST, 396 SMITHTOWN, NY 11787 | $10K |
| WINSTON SUPPORT SERVICES LLC EIN 80-0004314 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $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 | 3,356 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 697 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,053 | 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.