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 |
|---|---|---|---|
| GOWELL-NELSON, LINDA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $258K |
| H&H GRAPHIC PRINTING COMMUNICATIONS EIN 06-1648637 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $155K |
| LEGGIO, JAMES EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $144K |
| BARRY, JAMES P EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $141K |
| PRIGO, NICHOLAS EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| BRACCIOLI, ADRIANA ALEJANDRA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| GONZALEZ, JOSE EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $126K |
| MULDOON, ROBERT EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $123K |
| PUERTA-LOPEZ, JESUS JOHNI EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $115K |
| THERING, THOMAS EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $112K |
| THOMAS, TY-JAMAR RYAN EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $109K |
| ANDREWS, BENJAMIN EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| TERRY, FREDERICK C EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $103K |
| WINGATE, DONALD EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $100K |
| MARIN, ORLANDO EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $99K |
| HARRIS, RICHARD EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $95K |
| CAMPOS, JHOANNA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| ROLAND, JOSEPH P EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $92K |
| RAMOS, AWILDA EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| BALOBIN, DENIS EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| CUNNINGHAM, JOSEPH EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| PUENTE, CAROLINA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $87K |
| MENDELSOHN, ERIKA EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $85K |
| VELAZQUEZ, IVONNE EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| OSBORNE, MARGOT H EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| ORNDOFF, ROBERT EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| FOBI, KENNETH EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $78K |
| AGUILAR, VICTOR EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $78K |
| GLUKHOV, ALEXANDER EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| ROSA, JOSE A EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| GREEN, MICHAEL EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| VELEZ, SONIA ROSA EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $75K |
| OLIVERA SR, VICTOR EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| OKU, PRINCE EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
| MORTIMER, MICHAEL EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| MORENO, GLENDA EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $71K |
| MARTINEZ-HERNANDEZ, YOSSELYN EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $71K |
| MEDINA, JOSE M EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $70K |
| DOCEBO NA INC NONE | Other services; Direct payment from the plan Service code 49 | 600 N THOMAS ST SUITE A ATHENS, GA 30601 | $69K |
| RITTLE, KATY EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $67K |
| STOKES, ROBERT EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $67K |
| GAUTO, JULIO EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $66K |
| MELENDEZ-BENSON, AMY EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| UNIVERSAL PRINTING COMPANY EIN 43-0562133 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $57K |
| MERCADO, RAQUEL EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $52K |
| ADP, INC EIN 13-3036745 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $50K |
| BERKELEY LTC EIN 20-8249939 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $47K |
| THE BACHRACH GROUP LTD NONE | Direct payment from the plan; Other services Service code 49 | 1430 BROADWAY NEW YORK, NY 10018 | $42K |
| FRANKLYN, ASHTON EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $40K |
| RAMOS, LUIS EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $40K |
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 | 92,628 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 545 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 93,173 | 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.