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 |
|---|---|---|---|
| B. AFFETTO EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $78K |
| M. PRYOR EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $62K |
| G. SHAMOON EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $59K |
| B. RODRIGUEZ EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| R. LAINO EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $49K |
| V. NAPLES EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $47K |
| J. MARTINEZ EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $45K |
| R. CLANCY EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| B. MARTINEZ EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| C. LAINO EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $40K |
| S. JOHNSON EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| C. TOMINBERG EIN 36-3429967 TRUSTEE | Trustee (individual); Consulting (general) Service code 16 | — | $34K |
| G. YOUMANS EIN 36-3429967 TRUSTEE | Consulting (general); Trustee (individual) Service code 16 | — | $34K |
| C. JACOBAZZI EIN 36-6102397 EMPLOYEE | Employee (plan) Service code 30 | — | $26K |
| WILLIG, WILLIAMS & DAVIDSON EIN 23-2416488 NONE | Legal Service code 29 | — | $20K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $15K |
| CTM LEGAL EIN 46-1047517 OWNER IS BRO. OF TRUSTEE | Legal Service code 29 | — | $14K |
| VIVEKA HEALTH EIN 86-2467157 NONE | Other services Service code 49 | — | $12K |
| AMALGAMATED BANK EIN 36-0721895 NONE | Float revenue; Direct payment from the plan; Account maintenance fees; Custodial (other than securities) Service code 18 | — | $4K |
| COMERICA EIN 42-1741646 NONE | Float revenue; Other fees; Other investment fees and expenses; Investment management; Other services Service code 28 | — | $4K |
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 | 3,688 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,688 | 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.