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 |
|---|---|---|---|
| JAYSON MAKSYMOVICH EIN 22-1839567 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $197K |
| IBEW 269 LOCAL UNION EIN 21-0482996 RELATED FUND | Direct payment from the plan; Real estate brokerage Service code 32 | — | $140K |
| RACHEL CHAMBERLAIN EIN 22-1839567 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| TIMOTHY ROBERTO EIN 22-1839567 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $26K |
| MSPC EIN 22-2951202 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $11K |
| PELLETTIERI RABSTEIN & ALTMAN EIN 22-2353673 NONE | Legal; Direct payment from the plan Service code 29 | 989 LENOX DRIVE, 101 LAWRENCE TOWNSHIP, NJ 08648 | $8K |
| PFM & ADVISORS EIN 23-3087064 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $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 | 246 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 246 | 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."
No prospect flags tripped on this filing.