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 |
|---|---|---|---|
| INDEPENDENCE ADMINISTRATORS NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | PO BOX 826989 PHILADELPHIA, PA 191826989 | $1.1M |
| HORIZON BLUE CROSS BLUE SHIELD EIN 22-0999690 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $596K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $348K |
| CHARTWELL INVESTMENT PARTNERS, LLC EIN 36-4776242 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $300K |
| IAN RUEGG EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $196K |
| KROLL HEINEMEN CARTON EIN 76-0760981 NONE | Legal; Direct payment from the plan Service code 29 | — | $192K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $190K |
| MARY GULBRONSON EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $170K |
| BEN CAMACHO SR EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $157K |
| LEVEL CARE HEALTH CONSORTIUM NONE | Direct payment from the plan; Claims processing Service code 12 | 1811 SPRING GARDEN STREET PHILADELPHIA, PA 19130 | $157K |
| REVOLT GROUP LLC EIN 46-3524964 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $155K |
| RACHEL CORRADI EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $131K |
| DEBBIE KWIATEK EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $131K |
| KAREN KAUFMAN EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $127K |
| SUSANIN WIDMAN & BRENNAN PC EIN 23-2265950 NONE | Legal; Direct payment from the plan Service code 29 | — | $112K |
| NANCY MATHEWS EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $98K |
| JAY BUHAY EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| CAROL TUCKER EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $91K |
| MERRILYN GUARDINO EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $85K |
| NANCY GRATZEL EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $81K |
| MARY FITZPATRICK EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $81K |
| BEN KIESER EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $76K |
| JOANNE MANFRE EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| SHANNON WALKER EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $70K |
| PROFLEX ADMINISTRATORS LLC EIN 45-3261121 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $69K |
| EXPRESS SCRIPTS, INC EIN 22-3461740 NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $69K |
| CAROLE FACKINA EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| STEPHANIE ABASS SHEREEF EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $67K |
| JUDY ISAACS EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| JACQUELINE ERVIN EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| MAE HOWARD EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| DAWN CIRAKY EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $64K |
| JOE MORITKO EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| DAVE SHEOLA EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $61K |
| JARET GRANN EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $60K |
| SALLY RODRIGUEZ EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| EVELYN SOTO EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| DAN SEMENZA EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $57K |
| DESHELL CLARK EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| BENITO CAMACHO JR EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
| ANNE MAJOR EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $53K |
| MARIANNE SMITH EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| DULCE SYLVESTER EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $53K |
| DIANNE MODICA EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $53K |
| ANN MARIE TRIOLA EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| ELLA OILAM YUNG EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| FIRST ACTUARIAL CONSULTING, INC. EIN 26-3842522 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $49K |
| ELIZABETH SOTO EIN 22-6032181 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $49K |
| MILLICENT BEAUBOEUF EIN 22-6032181 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $48K |
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 | 5,632 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 5,632 | 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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.