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 |
|---|---|---|---|
| EXCELLUS BCBS EIN 15-0329043 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $218K |
| CORNELL POCHILY EIN 26-1694165 NONE | Direct payment from the plan; Investment management Service code 28 | — | $54K |
| BONADIO & CO., LLP NONE | Direct payment from the plan; Consulting (general); Accounting (including auditing) Service code 10 | 171 SULLYS TRL, STE 201 PITTSFORD, NY 14534 | $20K |
| CDLM & COMPANY LLP NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 401 E. STATE - SUITE 500 ITHACA, NY 14850 | $17K |
| ENV INSURANCE AGENCY, LLC EIN 16-1519815 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $16K |
| O'SULLIVAN ASSOCIATES EIN 20-8199367 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $13K |
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 | 421 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 421 | 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.