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 |
|---|---|---|---|
| LIFETIME BENEFIT SOLUTIONS EIN 16-1171765 NONE | Direct payment from the plan; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $653K |
| CORPORATE CARE MANAGEMENT EIN 16-1181119 NONE | Direct payment from the plan; Other services Service code 49 | — | $392K |
| PRIVATE HEALTHCARE SYSTEMS EIN 13-3068979 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $354K |
| SEI INVESTMENT MANAGEMENT CORP. EIN 23-1707341 INVESTMENT MANAGER | Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Investment management Service code 28 | — | $274K |
| DANIEL P. HARRIGAN EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $230K |
| DEBORAH SPAULDING EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $106K |
| ALLYHEALTH NONE | Direct payment from the plan; Other services Service code 49 | 1535 CHESTNUT ST #100 PHILADELPHIA, PA 19102 | $84K |
| CHRISTINE FIACCO EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| JEANNE TAINTER EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $76K |
| JOSEPH W. MCCARTHY & ASSOCIATES EIN 16-1120588 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $71K |
| NINA NICHOLSON EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| BLITMAN & KING, LLP EIN 16-1047304 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $60K |
| MULTIPLAN, INC. EIN 13-3068979 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $58K |
| CHRISTINE NASIATKA EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| DELTA DENTAL OF NY INC. EIN 11-1980218 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $56K |
| DEBORAH REINHART EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $48K |
| JOANN COOPER EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $47K |
| CAROL LOPARDI EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $46K |
| JENNIFER MCCORD EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $46K |
| LAURIE FREDETTE EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $46K |
| JENNIFER KNOX EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $43K |
| LACEY WHITE EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $43K |
| SLEVIN & HART, P.C. EIN 52-1708613 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $43K |
| KELLIE ELLSWORTH EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $40K |
| BOLTON PARTNERS,NE, INC. EIN 27-3666661 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $38K |
| COURTNEY EVANS EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $37K |
| CVS PHARMACY, INC. EIN 05-0340626 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $37K |
| KELLEY HARRIGAN EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| ENV INSURANCE AGENCY, LLC NONE | Other services; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 7789 OSWEGO RD LIVERPOOL, NY 13090 | $20K |
| JP MORGAN CHASE BANK, NA EIN 13-4994650 NONE | Direct payment from the plan; Float revenue Service code 50 | — | $20K |
| WELLS FARGO BANK NA EIN 94-1347393 NONE | Investment management fees paid directly by plan; Shareholder servicing fees; Custodial (securities); Investment management fees paid indirectly by plan Service code 19 | — | $12K |
| DAVIS VISION EIN 11-3051991 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $10K |
| TRI-DELTA RESOURCES EIN 16-1363868 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $9K |
| LAWLEY SERVICE INC. EIN 16-0802517 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $6K |
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 | 2,172 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 725 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,897 | 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.