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 |
|---|---|---|---|
| B BELL/P ROZELLE NFL PLAYER RET PL EIN 13-6043636 NONE | Other services; Direct payment from the plan Service code 49 | — | $9.3M |
| GROOM LAW GROUP, CHARTERED EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $6.5M |
| O'MELVENY & MYERS, LLP EIN 95-1066597 NONE | Legal; Direct payment from the plan Service code 29 | — | $4.5M |
| FTI CONSULTING (SC), INC. EIN 13-3128710 NONE | Legal; Direct payment from the plan Service code 29 | — | $749K |
| AON CONSULTING, INC. EIN 22-2232264 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $306K |
| SARAH LAHEY, PH.D. ABPP-CN EIN 87-3506111 NONE | Other services; Direct payment from the plan Service code 49 | — | $240K |
| AKIN GUMP STRAUSS HAUER & FELD LLP EIN 75-1338644 NONE | Legal; Direct payment from the plan Service code 29 | — | $229K |
| BARRY J. MCCASLAND, M.D., P.C. EIN 58-1318583 NONE | Other services; Direct payment from the plan Service code 49 | — | $229K |
| CORWIN BOAKE III, PH.D., P.C. EIN 81-3733552 NONE | Direct payment from the plan; Other services Service code 49 | — | $215K |
| ORTHOLONESTAR, PLLC EIN 84-2136648 NONE | Direct payment from the plan; Other services Service code 49 | — | $205K |
| OSU PSYCHIATRY, LLC EIN 20-0437235 NONE | Direct payment from the plan; Other services Service code 49 | — | $200K |
| ALL FLORIDA ORTHOPAEDIC ASSOCIATES EIN 59-2681990 NONE | Direct payment from the plan; Other services Service code 49 | — | $199K |
| PREM PARMAR, M.D. EIN 33-1010142 NONE | Direct payment from the plan; Other services Service code 49 | — | $193K |
| NEUROLOGY CLINIC OF JACKSONVILLE EIN 47-4331489 NONE | Other services; Direct payment from the plan Service code 49 | — | $190K |
| SYNERGY ORTHOPEDIC SPECIALISTS, INC EIN 45-5215138 NONE | Direct payment from the plan; Other services Service code 49 | — | $185K |
| PEACHTREE ORTHOPEDIC CLINIC EIN 58-1080740 NONE | Other services; Direct payment from the plan Service code 49 | — | $179K |
| ERNEST FUNG, PH.D. EIN 83-1448865 NONE | Other services; Direct payment from the plan Service code 49 | — | $173K |
| MATTHEW EDWARDS, M.D. EIN 88-2511245 NONE | Direct payment from the plan; Other services Service code 49 | — | $157K |
| INTEGRATED NEUROLOGY, P.A. EIN 27-0353595 NONE | Other services; Direct payment from the plan Service code 49 | — | $154K |
| DAVID SALISBURY, M.D., C.B. EIN 87-4730729 NONE | Other services; Direct payment from the plan Service code 49 | — | $146K |
| RESURGENS, LLC EIN 58-1661116 NONE | Direct payment from the plan; Other services Service code 49 | — | $141K |
| JASON A. KING, PH.D., LLC EIN 20-4222399 NONE | Direct payment from the plan; Other services Service code 49 | — | $141K |
| SILVANA RIGGIO, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 170 EAST 87TH STREET SUITE W20C NEW YORK, NY 10128 | $140K |
| F. HARLAN SELESNICK, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 7501 SW 104TH STREET MIAMI, FL 33156 | $138K |
| WILLIAM GARMOE, PH.D. NONE | Direct payment from the plan; Other services Service code 49 | 163 MITCHELLS CHANCE ROAD SUITE 114 EDGEWATER, MD 21037 | $135K |
| VIRGIL MEDLOCK III, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 4408 LIVINGSTON AVE DALLAS, TX 75205 | $130K |
| AAKASH SHAH, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 5701 WEST 119TH STREET SUITE 308 OVERLAND PARK, KS 66209 | $120K |
| MATTHEW W. NORMAN, M.D., LLC EIN 20-0332027 NONE | Direct payment from the plan; Other services Service code 49 | — | $119K |
| DEAN C. DELIS, CLINICAL PSYCH., INC EIN 81-0608729 NONE | Other services; Direct payment from the plan Service code 49 | — | $117K |
| CHARLENE BANG, PSYD NONE | Direct payment from the plan; Other services Service code 49 | 2500 JOHNSON AVENUE, #14H BRONX, NY 10463 | $111K |
| OSU NEUROSCIENCE CENTER, LLC EIN 31-1466115 NONE | Direct payment from the plan; Other services Service code 49 | — | $111K |
| MEDSTAR NATIONAL REHAB CENTER, INC. EIN 52-1369749 NONE | Other services; Direct payment from the plan Service code 49 | — | $110K |
| PAUL S. SAENZ, D.O., P.A. EIN 74-2613458 NONE | Direct payment from the plan; Other services Service code 49 | — | $106K |
| NEAL DEUTCH, PH.D. & ASSOCIATES EIN 48-1122260 NONE | Other services; Direct payment from the plan Service code 49 | — | $104K |
| VHS OUTPATIENT CLINICS, INC. EIN 62-1816823 NONE | Other services; Direct payment from the plan Service code 49 | — | $100K |
| GREGORY MACK, M.D., INC. EIN 20-4015690 NONE | Direct payment from the plan; Other services Service code 49 | — | $98K |
| WINSTON & STRAWN LLP EIN 36-1975990 NONE | Legal; Direct payment from the plan Service code 29 | — | $97K |
| THOMAS G. BURNS, PSY.D., ABPP-CN EIN 58-2262050 NONE | Other services; Direct payment from the plan Service code 49 | — | $97K |
| PERRY ORTHO & SPORTS MEDICINE, P.A. EIN 56-2258322 NONE | Other services; Direct payment from the plan Service code 49 | — | $97K |
| LAURA DESADIER, D.O. EIN 47-3033331 NONE | Direct payment from the plan; Other services Service code 49 | — | $97K |
| STEPHEN MACCIOCCHI, PH.D. NONE | Direct payment from the plan; Other services Service code 49 | P.O. BOX 189 MARBLE HILL, GA 30148 | $95K |
| KEVIN KESSLER, M.D., P.A. EIN 20-1388210 NONE | Other services; Direct payment from the plan Service code 49 | — | $91K |
| STEVEN EPSTEIN, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 2115 WISCONSIN AVENUE NW SUITE 200 WASHINGTON, DC 20007 | $90K |
| THE BANK OF NEW YORK MELLON EIN 13-5160382 NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $88K |
| LAURA LACRITZ, PH.D. EIN 75-6002868 NONE | Other services; Direct payment from the plan Service code 49 | — | $87K |
| OSARUMEN NICOLE DOGHOR, M.D. EIN 86-3317384 NONE | Other services; Direct payment from the plan Service code 49 | — | $84K |
| TARA VICTOR, PH.D., ABPP/ABCN NONE | Other services; Direct payment from the plan Service code 49 | 1247 7TH STREET SUITE 301 SANTA MONICA, CA 90404 | $84K |
| KRIEBEL & ASSOCIATES EIN 47-5477044 NONE | Direct payment from the plan; Other services Service code 49 | — | $82K |
| NICOLE WERNER, PH.D., LLC EIN 81-4319319 NONE | Direct payment from the plan; Other services Service code 49 | — | $82K |
| ERIC J. BRAHIN, M.D., PLLC EIN 46-4435141 NONE | Direct payment from the plan; Other services Service code 49 | — | $76K |
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 | 2,821 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,531 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6,770 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 13,122 | 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.