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 |
|---|---|---|---|
| OLIVIA CUGGY EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $262K |
| H&H GRAPHIC PRINTING COMMUNICATIONS EIN 06-1648637 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $254K |
| ISADORE HUSS EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $243K |
| CHRISTOPHER M RILEY EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $201K |
| DAVID PROJANSKY EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $190K |
| KIRK K PALMA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $189K |
| JAMES D FEKERT EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $184K |
| HUMBERTO DOMINGUEZ EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $176K |
| KIM L BARNETT EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $176K |
| STEVEN C MCGOWEN EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $176K |
| MICHELLE FREUDENBERGER EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $169K |
| EVELYN MASON EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $168K |
| NATALIA ANTROBUS EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $167K |
| MARIA NARANJO EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $165K |
| ELIZABETH ORTECHO EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $164K |
| GLORIA AGUIRRE EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $161K |
| PASCUALA RODRIGUEZ EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $143K |
| DAMARIS LANZO EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $143K |
| CESARINA PENA-TRABOUS EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $120K |
| GABOR BADENYI EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $116K |
| SRABONE MONIR EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $115K |
| JORGE HERRERA-DELEON EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $109K |
| LESLIE G TISHLER EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $107K |
| PAULIANA PAULINO EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $107K |
| JOCELYN INFANTE EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| SOPHIA VELEZ EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $104K |
| CARLA SEPULVEDA-ARMAS EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $100K |
| JOYCE VARGAS EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $99K |
| ANTOINETTE M LESLIE-HOLLAND EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| JEANETTE NUNEZ EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| JESSICA DUME EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| JANINA D CRAGWELL EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $94K |
| NATALIA MARTINEZ EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| ELIZABETH ALEMAN EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $92K |
| GINA CALERO EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| INGRIS DEL ROSARIO EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| MELISSA BETANCES EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| KATHERINE HERNANDEZ EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| YVONNE GIL EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $91K |
| THOMSON REUTERS NONE | Other services; Direct payment from the plan Service code 49 | PO BOX 6292 CAROL STREAM, IL 60197 | $90K |
| LIANNA LOPEZ EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| DARLYN TOLEDO-NARVAEZ EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| MARIA PEREZ EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| LESLIE ANN MARTINEZ EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $88K |
| STACY BUSHAY-MORRISON EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| GENESIS FANINI EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| MATTHEW NAVIDBAKHSH EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| LYDIA SHABAAN EIN 13-6841620 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $76K |
| AILEEN REYNA EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $69K |
| SEAN HECTOR TOLAND MATOS EIN 13-6841620 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $67K |
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 | 93,934 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36,467 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21,764 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152,165 | 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.