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 |
|---|---|---|---|
| CUGGY OLIVIA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $245K |
| SNYDER ALAN M EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $233K |
| HUSS ISADORE B EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $227K |
| H AND H GRAPHIC PRINTING COMMUNICAT EIN 06-1648637 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $201K |
| RILEY CHRISTOPHER M EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $188K |
| PALMA KIRK K EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $177K |
| PROJANSKY DAVID M EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $174K |
| FEKERT JAMES D EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $173K |
| MCGOWEN STEVEN C EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $166K |
| BARNETT KIM L EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $166K |
| DOMINGUEZ HUMBERTO S EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $165K |
| FREUDENBERGER MICHELLE EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $158K |
| ANTROBUS NATALIA L EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $158K |
| MASON EVELYN I EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $158K |
| TURLEY KATHLEEN EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $154K |
| ORTECHO ELIZABETH EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $153K |
| AGUIRRE GLORIA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $151K |
| RODRIGUEZ PASCUALA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $134K |
| LANZO DAMARIS EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $133K |
| HOWELL LISA EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $113K |
| PENATRABOUS CESARINA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $112K |
| FERNANDEZ CHRISTINA EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $111K |
| TISHLER LESLIE G EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $110K |
| MONIR SRABONE EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $109K |
| SELIEM MONERA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $108K |
| BADENYI GABOR EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $107K |
| PAULINO PAULIANA EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $99K |
| INFANTE JOCELYN EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $98K |
| VELEZ SOPHIA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| GUISAO JEANNETTE EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| SEPULVEDAARMAS CARLA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $92K |
| VARGAS JOYCE EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $92K |
| LESLIEHOLLAND ANTOINETTE M EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| CRAGWELL JANINA D EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| MARTINEZ NATALIA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| SORIA MARIA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| DUME JESSICA EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $88K |
| OLMEDORAMIREZ SERGIO EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $88K |
| NUNEZ JEANETTE EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $88K |
| CALERO GINA EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| HERRERADELEON JORGE EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $86K |
| GIL YVONNE EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $85K |
| BETANCES MELISSA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $85K |
| ALEMAN ELIZABETH EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $85K |
| GARCIA SHEILA EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| DELROSARIO INGRIS EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| SHABAAN LYDIA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| HERNANDEZ RAISA EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| MARYUK OLENA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
| REYNA AILEEN EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
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 | 99,925 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36,426 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 20,410 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 156,761 | 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.