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 | Direct payment from the plan; Employee (plan) Service code 30 | — | $293K |
| NICHOLAS PRIGO, LLC EIN 88-3180023 NONE | Direct payment from the plan; Other services Service code 49 | — | $254K |
| DG3 NORTH AMERICA, INC. EIN 22-2478136 NONE | Direct payment from the plan; Other services Service code 49 | — | $236K |
| INTERPLAY LEARNING, INC. NONE | Direct payment from the plan; Other services Service code 49 | 1717 W 6TH ST SUITE 405 AUSTIN, TX 78703 | $212K |
| H&H GRAPHIC PRINTING COMMUNICATIONS EIN 27-0771521 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $202K |
| JAMES, WILLIAM EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $193K |
| BARRY, JAMES P EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $172K |
| BRACCIOLI, ADRIANA ALEJANDRA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $172K |
| VEERAPATHRAN, GODWIN EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $164K |
| THERING, THOMAS EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $152K |
| GAUTO, JULIO EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $141K |
| RAUCHER, GLENN MICHAEL EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $141K |
| GONZALEZ, JOSE EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $138K |
| CUNNINGHAM, JOSEPH EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $137K |
| PUERTA LOPEZ, JESUS JHONI EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $135K |
| ZAMBRANO-LOPEZ, ANA R EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $131K |
| BOREN-KAPADIA, MICHAELA EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $129K |
| DYER, TIMOTHY EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $129K |
| GWP INC. EIN 20-8217385 NONE | Direct payment from the plan; Other services Service code 49 | — | $128K |
| LUCAS, JASON BERNARD EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| RYAN, TY-JAMAR EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| GUERRERO, JHOANNA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| BRUMLEY, STEVEN EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $126K |
| TRAVERS, JUDITH EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $125K |
| CANTRES, EMMANUEL EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $122K |
| WINGATE, DONALD EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $122K |
| MARIN, ORLANDO EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $122K |
| ANDREWS, BENJAMIN EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $121K |
| NATHANSON, ADAM WOODROW EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $116K |
| LOZA, EFRAIN EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $116K |
| RUEDA, LIBARDO EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $116K |
| JOSEPHS, SELINA EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $114K |
| AGUILAR, VICTOR EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $114K |
| POSTMASTER NONE | Direct payment from the plan; Other services Service code 49 | 421 8TH AVENUE WINDOW 76 NEW YORK, NY 101999998 | $112K |
| ORNDOFF, ROBERT EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $110K |
| CORTEZ, CARLOS EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $108K |
| URENA, ANTHONY EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $107K |
| FRANKLYN, ASHTON EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $106K |
| ROLAND, JOSEPH EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| PHILLIP, AKIDA EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| MEDINA, JOSE M EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $101K |
| TUDOSA, PATRICIA ANCA EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $100K |
| ZURAWSKI, PAUL EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $98K |
| SANTIAGO, THOMAS EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| OSBORNE, MARGOT H EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| BARRAGAN RAMOS, DENIS EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $92K |
| SEVERINO, YANIREL EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $91K |
| HOME DEPOT EIN 95-3261426 NONE | Direct payment from the plan; Other services Service code 49 | — | $91K |
| MARCOVICI, DANIEL EIN 23-7424757 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $90K |
| MORTIMER, MICHAEL EIN 23-7424757 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
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 | 119,154 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,517 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121,671 | 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.