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 |
|---|---|---|---|
| SIMON E. DAVIS EIN 52-0953443 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 6610 TRIBUTARY STREET SUITE 202 BALTIMORE, MD 21224 | $152K |
| STEPHEN LUKIEWSKI EIN 52-0953443 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 6610 TRIBUTARY STREET SUITE 202 BALTIMORE, MD 21224 | $146K |
| RICHARD P. POREMSKI EIN 52-0953443 PLAN EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 6610 TRIBUTARY STREET SUITE 202 BALTIMORE, MD 21224 | $133K |
| TMDG, LLC EIN 03-0583064 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 500 E PRATT STREET SUITE 525 BALTIMORE, MD 21202 | $25K |
| ABATO, RUBENSTEIN & ABATO, PA EIN 52-0904713 NONE | Legal; Direct payment from the plan Service code 29 | 809 GLENEAGLES COURT SUITE 320 BALTIMORE, MD 21286 | $23K |
| STA OF BALTIMORE INFO SERVICES, INC EIN 52-1331539 NONE | Other services; Direct payment from the plan Service code 49 | 8615 RIDGELYS CHOICE DRIVE SUITE 202 BALTIMORE, MD 21236 | $10K |
| TRAVELERS EIN 41-0518860 NONE | Insurance brokerage commissions and fees Service code 53 | 7070 PENNSYLVANIA DRIVE SUITE 110 EXTON, PA 19341 | $6K |
| M&T TRUST COMPANY EIN 16-0538020 TRUSTEE | Investment management Service code 28 | ONE MT PLAZA BUFFALO, NY 14203 | $2K |
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 | 988 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | 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.