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 |
|---|---|---|---|
| DENTAL DELIVERY SYSTEMS EIN 22-2020659 | Other services Service code 49 | — | $2.8M |
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 | Claims processing Service code 12 | THREE PENN PLAZA EAST NEWARK, NJ 071052200 | $1.9M |
| MAXON ADMINISTRATORS,INC. EIN 13-1883662 | Contract Administrator Service code 13 | — | $1.6M |
| JOHN NICCOLLAI MEDICAL CENTER EIN 22-2919559 | Other services Service code 49 | — | $1.3M |
| ANTHONY J. BONI EIN 22-1903961 | Other services Service code 49 | — | $956K |
| STACEY BRAUN ASSOCIATES, INC EIN 13-2889432 | Investment management fees paid directly by plan Service code 51 | — | $216K |
| STEVEN KAPLAN EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $200K |
| ANDREW BOLDUC EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $139K |
| MURPHY ANDERSON PLLC EIN 26-3092374 | Legal Service code 29 | — | $126K |
| KATHLEEN PRIDMORE EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $115K |
| PNC BANK NA EIN 22-1146430 | Investment management fees paid directly by plan Service code 51 | — | $105K |
| MERRILL LYNCH PIERCE FENNER & SMITH EIN 13-5674085 | Securities brokerage; Investment advisory (plan); Custodial (other than securities) Service code 18 | — | $98K |
| UFCW LOCAL 1 EIN 15-0559586 | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $98K |
| MICHAEL TORTORELLI EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $87K |
| JOSEPH JEWELL EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $81K |
| TIMOTHY COPPO EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $81K |
| VINCENT PISCITELLI EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $76K |
| KATHLEEN STEIMLE EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| SHARON O'CONNOR EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| CONCERNED DENTAL CARE OF WESTCHESTE EIN 20-0904327 | Other services Service code 49 | — | $60K |
| ROSENBERG,RICH,BAKER,BERMAN & EIN 22-3271252 | Accounting (including auditing) Service code 10 | — | $54K |
| RICHARD KITTI EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| UMBERTO MARICONDA EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $49K |
| NANCY MALAVE EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| JOANN PISCITELLI EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| JANIS COE EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $40K |
| SAVASTA & CO. INC. EIN 13-3879959 | Actuarial Service code 11 | — | $34K |
| JENNIFER SUDOL EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $34K |
| VITO LAMPARIELLO EIN 22-1582446 EMPLOYEE | Employee (plan) Service code 30 | — | $33K |
| BENNETT ROTHENBERG, M.D. EIN 13-5484940 | Other services Service code 49 | — | $20K |
| MIZZONE & TESTA LAW FIRM EIN 20-1020882 CONSULTANT | Legal Service code 29 | — | $8K |
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 | 11,742 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 105 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,847 | 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.