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 |
|---|---|---|---|
| HEALTHCARE SERVICE CORPORATION EIN 36-1236610 NONE | Other insurance fees and expenses; Claims processing Service code 12 | — | $924K |
| ULLICO INVESTMENT ADVISORS INC. EIN 52-6435649 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $375K |
| ZELIS PAYMENTS HOLDINGS LLC EIN 84-3069529 NONE | Other services Service code 49 | — | $347K |
| J.P. MORGAN INVESTMENT MANAGEMENT EIN 13-3200244 NONE | Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Investment management; Investment advisory (plan) Service code 27 | — | $249K |
| VITECH SYSTEMS GROUP INC EIN 13-3785492 NONE | Other services Service code 49 | — | $229K |
| LOOMIS SAYLES & COMPANY EIN 20-8080381 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $208K |
| NATIONAL INV. SERV. OF AMERICA LLC EIN 84-3937993 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $193K |
| SEGAL EIN 13-1975125 NONE | Other services; Actuarial Service code 11 | — | $173K |
| DELTA DENTAL PLAN OF ILLINOIS EIN 36-2612058 NONE | Claims processing Service code 12 | — | $134K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 10 | — | $132K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $108K |
| R. TORANO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $108K |
| P. WALLACE EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $106K |
| G. R. LISKA EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $89K |
| L. WILLIAMS EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $89K |
| M. CHRISTOPHER EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $87K |
| V. HOANG EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $86K |
| A. CAROLLO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $86K |
| G. HARKNESS EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $83K |
| C. WENSKUS EIN 46-5243652 ADMINISTRATOR | Plan Administrator Service code 14 | — | $81K |
| R. MARCELLO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $81K |
| S. SCHUMANN EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $80K |
| J. GILLERAN EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $78K |
| A. GROSSI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $76K |
| T. MARSHALL EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $74K |
| FIS WORKFLOW SOLUTIONS EIN 51-0267091 NONE | Other services Service code 49 | — | $73K |
| Y. MELTSER EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $72K |
| R. LACEY EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $67K |
| S. CHEUNG EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| K. DECIANNI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| VISION SERVICE PLAN EIN 20-0891619 NONE | Claims processing Service code 12 | — | $64K |
| L. HOWARD EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $63K |
| BNY MELLON EIN 84-7062700 NONE | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Soft dollars commissions Service code 51 | — | $59K |
| M. MILLS EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $59K |
| S. PAGURKO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| D. PANZO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| K. JACKSON EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| J. SUERO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $58K |
| D. WILLIAMS EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| M. PECK EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| S. COLLINS EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| P. LOMBARDI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| M. CORNEJO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| M. CANNELLA EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| L. ANDRADE EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| N. GALLUZZI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| K. BURDINE EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $51K |
| ALLISON, SLUTSKY & KENNEDY, PC EIN 36-3994099 NONE | Legal Service code 29 | — | $51K |
| J. COLLETTI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $50K |
| E. MCKINLEY EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $50K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6,195 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,195 | 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. Catastrophic-risk exposure; stop-loss specialist sales target.