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 fees Service code 99 | — | $1.2M |
| CAREMARK EIN 05-0340626 NONE | Claims processing Service code 12 | — | $129K |
| DELTA DENTAL PLAN OF ILLINOIS EIN 36-2612058 NONE | Claims processing Service code 12 | — | $118K |
| BANSLEY & KIENER, LLP EIN 36-2152389 NONE | Accounting (including auditing) Service code 10 | — | $95K |
| VSG HOSTING EIN 20-4487588 NONE | Other services Service code 49 | — | $86K |
| ALLISON, SLUTSKY & KENNEDY, PC EIN 36-3994099 NONE | Legal Service code 29 | — | $77K |
| J. JORGENSEN EIN 46-5243652 ADMINISTRATOR | Plan Administrator Service code 14 | — | $76K |
| NATIONAL INVESTMENT SERVICES EIN 80-0169636 NONE | Investment management fees paid directly by plan Service code 51 | — | $66K |
| J. OLSZEWSKI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $66K |
| P. WALLACE EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $64K |
| VITECH SYSTEMS GROUP INC EIN 13-3785492 NONE | Other services Service code 49 | — | $62K |
| LEGACY PROFESSIONALS, LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $61K |
| R. TORANO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Actuarial Service code 11 | — | $57K |
| E. MASHOS EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $55K |
| M. CHRISTOPHER EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| J. FOSCO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $53K |
| L. WILLIAMS EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| K. DECIANNI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| J. GILLERAN EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| R. MARCELLO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $51K |
| VISION SERVICE PLAN EIN 20-0891619 NONE | Claims processing Service code 12 | — | $50K |
| V. HOANG EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $49K |
| J. SUREO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $48K |
| G. PORTER EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $45K |
| D. FRON EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $44K |
| D. HAYDUCK EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $42K |
| K. FLUCK EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $42K |
| FIS WORKFLOW SOLUTIONS NONE | Other services Service code 49 | 104 INVERNESS CENTER PARKWAY BIRMINGHAM, AL 35242 | $42K |
| Y. MELTSER EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| C. WENSKUS EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $41K |
| T. MARSHALL EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $38K |
| R. LISKA EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| OGLETREE DEAKINS NASH ET AL., P.C. EIN 57-1044820 NONE | Legal Service code 29 | — | $37K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $37K |
| A. GROSSI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $37K |
| D. CAPASSO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $36K |
| V. SCALETTA EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $36K |
| D. PANZO EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $36K |
| K. TARJAN EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| C. HOFFMAN EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $35K |
| P. LOMBARDI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $34K |
| C. FORD EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $34K |
| M. CANNELLA EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $33K |
| K. VANEK MOSENSON EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $33K |
| L. VONDRA EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $33K |
| C. PISANI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| B. ROBINSON EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| L. HOWARD EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
| J. COLLETTI EIN 46-5243652 EMPLOYEE | Employee (plan) Service code 30 | — | $32K |
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 | 4,464 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,464 | 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.