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 | — | $257K |
| H & H GRAPHIC PRINTING COMMUNICATIO EIN 06-1648637 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $194K |
| LEGGIO JAMES N EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $152K |
| PRIGO NICHOLAS EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $149K |
| BARRY JAMES P EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $147K |
| BRACCIOLI ADRIANA A EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $141K |
| MULDOON ROBERT EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $126K |
| GONZALEZ JOSE EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $125K |
| THERING THOMAS EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $123K |
| PUERTA LOPEZ JESUS JHONI EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $123K |
| GAUTO JULIO EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $116K |
| THOMAS TYJAMAR EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $116K |
| STOKES ROBERT L EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $114K |
| BECERRA JESUS EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $112K |
| ANDREWS BENJAMIN EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $111K |
| BRUMLEY STEVEN EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $111K |
| MEDINA JOSE EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $111K |
| GUERRERO JHOANNA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $107K |
| HARRIS RICHARD EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $106K |
| WINGATE DONALD EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| CERTUS CONTROLS LLC NONE | Consulting (general); Other services; Direct payment from the plan Service code 16 | 154 TOLEDO ST FARMINGDALE, NY 11735 | $101K |
| MELENDEZ BENSON AMY ELIZABETH EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $100K |
| MARIN ORLANDO EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $99K |
| JOSEPHS SELINA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $97K |
| CORTEZ CARLOS EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $96K |
| ROLAND JOSEPH EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| ROSA JOSE A EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| CUNNINGHAM JOSEPH EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| ORNDOFF ROBERT EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $94K |
| RAMOS AWILDA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| REID JUSTIN EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $91K |
| PUENTE CAROLINA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| OSBORNE MARGOT H EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $87K |
| URENA ANTHONY EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $87K |
| RITTLE KATY EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $86K |
| GLUKHOV ALEXANDER EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| ZAMBRANOLOPEZ ANA R EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| AGUILAR VICTOR EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| NISIVOCCIA RENEE EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $86K |
| VELEZ SONIA ROSA EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| TRAVERS JUDITH EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| MORTIMER MICHAEL EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $81K |
| OLIVERA VICTOR H SR EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $80K |
| PHILLIP AKIDA EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| DE PINA ADELINA F EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| MORENO GLENDA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $76K |
| RUEDA LIBARDO EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $74K |
| BRISTOL EDUARDO EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $73K |
| ADP LLC EIN 13-3036845 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $73K |
| LOZA EFRAIN EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $72K |
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 | 103,765 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,746 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 106,511 | 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.