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 |
|---|---|---|---|
| ANDREW MILLICHIP EIN 13-6264730 EMPLOYEE | Employee (plan) Service code 30 | 10 EXCHANGE PLACE SUITE 1400 JERSEY CITY, NJ 07302 | $132K |
| JOSEPH GIOENI EIN 13-6264730 EMPLOYEE | Employee (plan) Service code 30 | 10 EXCHANGE PLACE SUITE 1400 JERSEY CITY, NJ 07302 | $93K |
| MILA MANAGED HEALTH CARE EIN 13-3968546 HEALTH INSURANCE | Insurance services Service code 23 | 55 BROADWAY 27TH FLOOR NEW YORK, NY 10006 | $44K |
| THE LAMBOS FIRM LLP EIN 13-3864093 NYSA COUNSEL | Legal Service code 29 | 303 SOUTH BROADWAY SUITE 410 TARRYTOWN, NY 10591 | $20K |
| MAZZOLA MARDON, P.C. EIN 13-3303633 ILA COUNSEL | Legal Service code 29 | 39 BROADWAY 34TH FLOOR NEW YORK, NY 10006 | $20K |
| DESENA & COMPANY EIN 20-0609534 AUDITOR | Accounting (including auditing) Service code 10 | 100 EAGLE ROCK AVENUE SUITE 110 EAST HANOVER, NJ 07936 | $20K |
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 | 4,202 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 20 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 4,232 | 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.