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 EIN 06-6033492 NONE | Direct payment from the plan; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $685K |
| NOVA HEALTHCARE ADMINISTRATORS EIN 16-6443379 NONE | Claims processing; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $294K |
| SEI INVESTMENT MANAGEMENT CORP. EIN 23-1707341 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Investment management Service code 28 | — | $292K |
| DEBORAH SPAULDING EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $178K |
| JOSEPH W. MCCARTHY & ASSOCIATES EIN 16-1120588 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $119K |
| SLEVIN & HART, P.C EIN 52-1708613 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $102K |
| CHRISTINE FIACCO EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $98K |
| LAURIE FREDETTE EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| VICKIE CROAD EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| NINA NICHOLSON EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| CHRISTINE NASIATKA EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| JENNIFER MCCORD EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $74K |
| PEGEEN JACKSON EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| VICTORIA COLE EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| OPTUM RX EIN 33-0441200 NONE | Other fees; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $69K |
| KELLIE ELLSWORTH EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| SARAH QUINN EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| KELLEY HARRIGAN EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| DELTA DENTAL OF NY INC. EIN 11-1980218 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $53K |
| APRIL MCCORD EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| PATRICIA REITZ EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| BLITMAN & KING, LLP EIN 16-1047304 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $45K |
| BOLTON PARTNERS NE, INC. EIN 27-3666661 NONE | Finders' fees / placement fees; Direct payment from the plan; Actuarial Service code 11 | — | $41K |
| CHRIS SPAULDING EIN 15-0582931 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $39K |
| ARCARA. ZUCARELLI, LENDA & ASSOC. EIN 47-1793720 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $34K |
| DEBORAH REINHART EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $32K |
| COURTNEY EVANS EIN 15-0582931 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $32K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 27-3888881 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $26K |
| AP BENEFIT ADVISORS LLC EIN 30-0837157 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $21K |
| VITEC SOLUTIONS EIN 20-2309384 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $18K |
| PRINCIPAL EIN 51-0099493 NONE | Direct payment from the plan; Custodial (securities); Distribution (12b-1) fees Service code 19 | — | $14K |
| DAVIS VISION EIN 11-3051991 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $11K |
| UPSTATE ADVISORS GROUP EIN 16-1540179 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $10K |
| SEGAL SELECT INSURANCE SERVICES, IN EIN 46-0619194 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $9K |
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 | 2,439 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 558 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,997 | 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.