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 LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $438K |
| HCC LIFE INSURANCE COMPANY EIN 35-1817054 NONE | Insurance services Service code 23 | 225 TOWNPARK DRIVE KENNESAW, GA 30144 | $343K |
| MILLIMAN USA EIN 91-0675641 NONE | Actuarial Service code 11 | 250 WASHINGTON AVE EXT ALBANY, NY 122035401 | $97K |
| KINGSTON WORX EIN 14-1349558 NONE | Other services Service code 49 | 25 BARBAROSA LANE KINGSTON, NY 12401 | $35K |
| RBT CPAS, LLP EIN 14-1604297 NONE | Accounting (including auditing) Service code 10 | 11 RACQUET ROAD NEWBURGH, NY 12550 | $29K |
| KNIGHT INSURANCE GROUP NONE | Insurance agents and brokers Service code 22 | 4751 WILSHIRE BLVD ST 111 LOS ANGELES, CA 90010 | $21K |
| MARQUETTE ASSOCIATES, INC. NONE | Consulting fees Service code 70 | 180 NORTH LASALLE STREET CHICAGO, IL 60601 | $20K |
| ROBERT M. CHEVERIE & ASSOCIATES, PC NONE | Legal Service code 29 | 333 EAST RIVER DR STE 101 EAST HARTFORD, CT 06108 | $18K |
| EMERGENCY ONE NONE | Other services Service code 49 | 306 WINDSOR HWY NEW WINDSOR, NY 12553 | $18K |
| J.A. MARIANO AGENCY NONE | Insurance agents and brokers Service code 22 | 679 LANDIS AVE,PO BOX 390 ROSENHAYN, NJ 08352 | $11K |
| LOWER HUDSON VALLEY EAP NONE | Other services Service code 49 | 3505 HILL BLVD - SUITE A 914-245-6300 YORKTOWN HEIGHTS, NY 10598 | $10K |
| HGK ASSET MANAGEMENT EIN 52-1296988 NONE | Investment management fees paid directly by plan Service code 51 | 525 WASHINGTON BLVD JERSEY CITY, NJ 07310 | $9K |
| SPECTRUM PENSION AND COMPENSATION EIN 14-1764716 NONE | Consulting (general) Service code 16 | 11 RACQUET ROAD NEWBURGH, NY 12550 | $9K |
| ULLICO RETIREMENT SOLUTIONS NONE | Investment management fees paid directly by plan Service code 51 | 14755 NORTH OUTER FORTY ST LOUIS, MO 63017 | $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 | 548 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 111 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 84 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 743 | 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.