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 |
|---|---|---|---|
| MERITAIN HEALTH NONE | Claims processing; Direct payment from the plan Service code 12 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $1.5M |
| LABOR FIRST LLC EIN 06-1750191 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 1000 MIDLANTIC DRICE STE 100 MOUNT LAUREL, NJ 08054 | $785K |
| M. COLLOM EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $203K |
| K. O'MARA EIN 43-0657966 NONE | Direct payment from the plan Service code 50 | — | $183K |
| COMMERCE TRUST COMPANY EIN 43-0356370 NONE | Investment management fees paid directly by plan; Shareholder servicing fees; Custodial (securities) Service code 19 | — | $175K |
| P. GALLAGHER EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $174K |
| ANDERS MINKLER HUBER & HELM LLP EIN 43-0831507 NONE | Consulting fees; Consulting (general); Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $169K |
| DELTA DENTAL EIN 43-0908349 NONE | Claims processing; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $167K |
| T. MADDEN EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $151K |
| S. PEROTTI EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $147K |
| MAXORPLUS PHARMACY BENEFIT NONE | Other services; Direct payment from the plan Service code 49 | 320 S. POLK ST. 200 AMARILLO, TX 79101 | $146K |
| S. KIELY EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $146K |
| J. SUMMERS EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $143K |
| D. O'CONNELL EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $140K |
| J. SANSONE EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $140K |
| T. BIELICKI EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $137K |
| K. MCDONOUGH EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $136K |
| A. CAMMARATA EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $133K |
| B. HOWELL EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $128K |
| B. FLYNN EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $120K |
| J. HICKEY EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $119K |
| M. HEPBURN EIN 43-0657966 NONE | Direct payment from the plan Service code 50 | — | $117K |
| L. SCHAFER EIN 43-0657966 NONE | Direct payment from the plan Service code 50 | — | $116K |
| C. LOCK EIN 43-0657966 NONE | Employee (plan) Service code 30 | — | $115K |
| ZELIS NONE | Other services; Direct payment from the plan Service code 49 | 149 NEWBURY STREET 5TH FLOOR BOSTON, MA 02116 | $111K |
| HARTNETT REYES-JONES, LLC EIN 43-1205253 NONE | Direct payment from the plan; Legal Service code 29 | — | $110K |
| K. BUSHMAN EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $110K |
| N. BORDERS EIN 43-0657966 NONE | Direct payment from the plan Service code 50 | — | $109K |
| M. BURTON EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $101K |
| M. MENSIO EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $99K |
| C. CHRISTIAN-BRICE EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $99K |
| K. JOHNDROW EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $95K |
| SAV RX NONE | Other services; Direct payment from the plan Service code 49 | 224 NORTH PARK AVENUE FREMONT, NE 68025 | $94K |
| M. HARCHARIK EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $92K |
| L. DELUCA EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| M. DANCHUS EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $89K |
| S. GEORGER EIN 43-0657966 NONE | Employee (plan) Service code 30 | — | $86K |
| D. O'NEAL EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $86K |
| M. SANDERS EIN 43-0657966 NONE | Employee (plan) Service code 30 | — | $86K |
| C. NENNINGER EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $85K |
| J. DISKO EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| K. HOLDMEYER EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $84K |
| B. FINK EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $83K |
| S. HUNT EIN 43-0657966 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| D. SKILJAN EIN 43-0657966 NONE | Employee (plan) Service code 30 | — | $79K |
| PBIRX NONE | Direct payment from the plan; Other services Service code 49 | 612 WHEELERS FARMS ROAD MILFORD, CT 06461 | $79K |
| E. GEORGER EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $78K |
| C. SELLINI EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $78K |
| UNITED ACTUARIAL SERVICES NONE | Direct payment from the plan Service code 50 | 11590 N MERIDIAN ST, STE 610 CARMEL, IN 46032 | $77K |
| C. SCHULTE EIN 43-0657966 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $74K |
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 | 2,918 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,744 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,662 | 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. Exposed to catastrophic claims. Stop-loss sales target.