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 |
|---|---|---|---|
| MAGNACARE ADMINISTRATIVE SERVICES EIN 11-3410766 NONE | Direct payment from the plan; Claims processing; Other services Service code 12 | — | $808K |
| VIVEKA HEALTH, INC. EIN 47-2378254 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $421K |
| MARC GOODMAN EIN 13-5555808 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $317K |
| PAYER MATRIX, LLC NONE | Other services; Other fees Service code 49 | 407 ELMWOOD AVE. SHARON HILL, PA 19079 | $212K |
| CAROLYN ECHOLS EIN 13-5555808 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $153K |
| MARIA BANCHS EIN 13-5555808 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $113K |
| SELE-DENT, INC. NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | 1 HUNTINGTON QUADRANGLE MELVILLE, NY 11747 | $110K |
| DANICA PADRO EIN 13-5555808 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $106K |
| TEAMSTER CENTER SERVICES EIN 13-1964856 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $100K |
| ANNABELLE SOTO EIN 13-5555808 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| DAELLA BARBERENA EIN 13-5555808 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $93K |
| EMILY HERNANDEZ EIN 13-5555808 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $91K |
| JOLENE VICTORIA EIN 13-5555808 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $91K |
| ALICARE MEDICAL MANAGEMENT EIN 13-3860528 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $65K |
| JOSEPH STERN & CO. EIN 11-2767324 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $63K |
| JEFFREY S. DUBIN P.C. EIN 45-4939702 NONE | Legal; Direct payment from the plan Service code 29 | — | $60K |
| CARLOS RANGEL CPA PC NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 200 PARK AVENUE NEW YORK, NY 10166 | $55K |
| PITTA LLP EIN 26-3852082 LEGAL COUNSEL | Legal; Direct payment from the plan Service code 29 | — | $52K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $50K |
| EMPIRX EIN 47-1226691 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $50K |
| ATALANTA SOSNOFF EIN 20-0461050 NONE | Investment management; Direct payment from the plan Service code 28 | — | $28K |
| THE SEGAL COMPANY (EASTERN STATES) EIN 13-1835864 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $25K |
| WELLS FARGO ADVISORS EIN 34-1542819 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $10K |
| TOP NOTCH SYSTEMS, INC. | Other services; Direct payment from the plan Service code 49 | 8 MARK DRIVE WESLEY HILLS, NY 10977 | $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 | 4,085 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,086 | 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.