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 |
|---|---|---|---|
| AETNA EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $118K |
| ARCHER BYINGTON GLENNON EIN 26-0873462 NONE | Legal Service code 29 | — | $106K |
| PAMELA BROWN EIN 13-6132502 EMPLOYEE | Employee (plan); Plan Administrator Service code 14 | — | $99K |
| MALONEY ASSOCIATES EIN 11-2219769 NONE | Claims processing Service code 12 | — | $96K |
| PATRICIA PERROTTA EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $75K |
| LISA ULEANO EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| JUSTYNA CYRULIK EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| MILLIMAN, INC EIN 91-0675641 NONE | Actuarial Service code 11 | — | $42K |
| YULIYANA HADZHIEV EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $33K |
| CARMELA MARINO EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $23K |
| MSPC EIN 22-2951202 NONE | Accounting (including auditing) Service code 10 | — | $20K |
| L. 363 JAT RE CORP. EIN 13-3765269 AFFILIATED BENEFIT FUND | Other fees Service code 99 | — | $19K |
| KRYSTYNA ANNUNZIATA EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $17K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 26-4310632 NONE | Other fees; Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Investment advisory (plan); Other commissions; Securities brokerage Service code 15 | — | $15K |
| AMANDA HEIM EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $8K |
| KORN ROSENBAUM, LLP EIN 13-2839140 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $7K |
| DELAWARE CAPITAL MANAGEMENT NONE | Investment management Service code 28 | 125 WEST 55TH STREET NEW YORK, NY 10019 | $6K |
| PACIFIC FIXED INCOME NONE | Investment management Service code 28 | 650 NEWPORT CENTER DRIVE NEWPORT BEACH, CA 92660 | $5K |
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 | 680 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 284 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 964 | 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.