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 |
|---|---|---|---|
| HEALTHSMART BENEFIT SOLUTIONS EIN 36-4099199 | Claims processing; Direct payment from the plan Service code 12 | — | $2.7M |
| AMBA ADMINISTRATORS INC. EIN 88-0647181 | Claims processing; Recordkeeping fees; Direct payment from the plan; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $2.6M |
| NYSUT MEMBER BENEFITS TRUST EIN 22-2480854 | Direct payment from the plan; Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $1.1M |
| STACEY BRAUN ASSOCIATES, INC EIN 13-2889432 | Soft dollars commissions; Investment advisory (plan); Direct payment from the plan Service code 27 | — | $660K |
| WEAVER AND TIDWELL, LLP EIN 75-0786316 | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $47K |
| THE SEGAL COMPANY (EASTERN STATES) EIN 13-1835864 | Consulting fees; Direct payment from the plan; Consulting (general); Actuarial Service code 11 | — | $42K |
| SEGAL MARCO ADVISORS EIN 13-2646110 | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $35K |
| MEYER, SUOZZI, ENGLISH & KLEIN P.C. EIN 11-2340639 | Legal; Direct payment from the plan Service code 29 | — | $27K |
| PJ GREEN INC. EIN 16-0983758 | Copying and duplicating; Direct payment from the plan; Participant communication Service code 36 | — | $9K |
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 | 20,575 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 31,884 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 52,459 | 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.