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 BCBS EIN 23-7391136 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $1.1M |
| ZENITH AMERICAN SOLUTIONS NONE | Contract Administrator; Direct payment from the plan Service code 13 | 10440 LITTLE PATUXENT PKW COLUMBIA, MD 21044 | $366K |
| VIRGINIA & AMBINDER EIN 13-4166736 NONE | Legal; Direct payment from the plan Service code 29 | 111 BROADWAY NEW YORK, NY 10006 | $229K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $176K |
| FERNANDO NETO EIN 13-5562753 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $151K |
| JOHN KOBEL EIN 13-5562753 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $140K |
| INTERCONTINENTAL NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 1270 SOLDIERS FIELD ROAD BOSTON, MA 02135 | $139K |
| CYNTHIA WONG EIN 13-5562753 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $133K |
| DENISE ALIOTO EIN 13-5562753 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $119K |
| CASTIGLIA LLP EIN 46-2725636 NONE | Direct payment from the plan; Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 10 | — | $105K |
| DIANNE BACCARI EIN 13-5562753 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $101K |
| ANDREA MARTINEZ EIN 13-5562753 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| MERRILL LYNCH EIN 13-5674085 NONE | Investment management; Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $88K |
| AZAHARA MAYO EIN 13-5562753 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| GORLICK, KRAVITZ & LISTHAUS EIN 13-3790829 NONE | Legal; Direct payment from the plan Service code 29 | — | $81K |
| ATALANTA SOSNOFF EIN 20-0461050 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $78K |
| LSV EIN 23-2772200 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $65K |
| LORD ABBETT NONE | Investment management; Direct payment from the plan Service code 28 | 90 HUDSON STREET JERSEY CITY, NJ 073023973 | $63K |
| KAREN PEREZ EIN 13-5562753 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $40K |
| PNC BANK EIN 22-1146430 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $19K |
| PART D ADVISORS | Consulting (general); Direct payment from the plan Service code 16 | 17199 N. LAUREL PK DR 400 LIVONIA, MI 48152 | $19K |
| QUADIANT | Direct payment from the plan; Other services Service code 49 | 1 PENN PLAZA NEW YORK, NY 10119 | $6K |
| UNION NETWORKING EIN 22-2940797 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $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 | 2,663 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 719 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,382 | 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.