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 |
|---|---|---|---|
| L. 363 JAT R.E. CORP. EIN 13-3765269 AFFILIATED ORGANIZATION | Other fees Service code 99 | — | $329K |
| CRAIG JACOBS EIN 13-6132505 EMPLOYEE | Employee (plan) Service code 30 | — | $118K |
| WILLIAM EDWARDS EIN 13-6132505 EMPLOYEE | Employee (plan) Service code 30 | — | $99K |
| NICOLE DE FELICE EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $79K |
| MORGAN STANLEY EIN 26-4310632 NONE | Other fees; Recordkeeping fees; Securities brokerage; Investment advisory (plan); Recordkeeping and information management (computing, tabulating, data processing, etc.); Other commissions; Other services Service code 15 | — | $23K |
| MSPC EIN 22-2951202 NONE | Accounting (including auditing) Service code 10 | — | $21K |
| CHRIS BISHOP EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $13K |
| JOHN WILSON EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $13K |
| JAMES MOORE EIN 13-6132505 EMPLOYEE | Employee (plan) Service code 30 | — | $12K |
| ROCCO MARINO EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $12K |
| CLINTON BROWN EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $11K |
| KENNETH MAZANEC EIN 13-6132505 EMPLOYEE | Employee (plan) Service code 30 | — | $9K |
| GARY DIMATTEO EIN 13-6132505 EMPLOYEE | Employee (plan) Service code 30 | — | $9K |
| ROBERT MCGRATH EIN 13-6132505 EMPLOYEE | Employee (plan) Service code 30 | — | $8K |
| GREGORY RUDZINSKI EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $8K |
| BERNARD & ASSOCIATES EIN 13-3774222 NONE | Accounting (including auditing) Service code 10 | — | $6K |
| EDWARD LEWIS EIN 13-6132502 EMPLOYEE | Employee (plan) Service code 30 | — | $6K |
| KYLE PARENZAN EIN 13-6132505 EMPLOYEE | Employee (plan) Service code 30 | — | $5K |
| RACHEL BOTBYL EIN 13-6132505 EMPLOYEE | Employee (plan) Service code 30 | — | $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 | 870 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 870 | 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."
No prospect flags tripped on this filing.