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 |
|---|---|---|---|
| BERT BELL/PETE ROZELLE NFL PLAYER EIN 13-6043636 NONE | Other services; Direct payment from the plan Service code 49 | — | $986K |
| GROOM LAW GROUP EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $523K |
| ALL FLORIDA ORTHOPAEDICS ASSOCIATES EIN 59-2681990 NONE | Other services; Direct payment from the plan Service code 49 | — | $231K |
| BERNSTEIN & MCCASLAND, MD, PC EIN 58-1318583 NONE | Direct payment from the plan; Other services Service code 49 | — | $192K |
| FONDREN ORTHOPEDIC GROUP, LLP EIN 76-0363583 NONE | Direct payment from the plan; Other services Service code 49 | — | $181K |
| DAVID APPLE, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 660 COLLIER COMMONS CIRCLE ATLANTA, GA 30318 | $176K |
| ATLANTA NEUROPSYCHOLOGY, LLC EIN 46-1232782 NONE | Other services; Direct payment from the plan Service code 49 | — | $157K |
| JOHNNY HUNG-CHI WEN, PHD EIN 20-8253877 NONE | Other services; Direct payment from the plan Service code 49 | — | $137K |
| ERIC J. BRAHIN, M.D., M.S.E NONE | Other services; Direct payment from the plan Service code 49 | 96 REYNOSA SAN ANTONIO, TX 78261 | $137K |
| ALLEN JACKSON NONE | Other services; Direct payment from the plan Service code 49 | PO BOX 188 MEDINA, WA 98039 | $132K |
| KANSAS CITY SPINE & SPORTS MED EIN 80-0609778 NONE | Other services; Direct payment from the plan Service code 49 | — | $124K |
| HARLAN SELESNICK, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 7501 SW 140TH STREET MIAMI, FL 33156 | $120K |
| STEVEN MEIER, M.D. EIN 26-2053717 NONE | Direct payment from the plan; Other services Service code 49 | — | $115K |
| ORRIN SHERMAN, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 114 EAST 72ND STREET 14C NEW YORK, NY 10021 | $101K |
| PAUL SAENZ, D.O., P.A. EIN 74-2613458 NONE | Other services; Direct payment from the plan Service code 49 | — | $92K |
| EDWARD O'CONNOR EIN 20-0579634 NONE | Other services; Direct payment from the plan Service code 49 | — | $91K |
| PEACHTREE ORTHOPAEDIC CLINIC EIN 58-2139816 NONE | Direct payment from the plan; Other services Service code 49 | — | $90K |
| AON EIN 22-2232264 NONE | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | — | $87K |
| ORTHOPAEDIC CARE SPECIALISTS EIN 65-0882367 NONE | Other services; Direct payment from the plan Service code 49 | — | $77K |
| H. HERNDON MURRAY, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 2001 PEACHTREE ROAD SUITE 705 ATLANTA, GA 30309 | $75K |
| WILLIAM GARMOE, PH.D. NONE | Other services; Direct payment from the plan Service code 49 | 14300 GALLANT FOX LANE SUITE 107 BOWIE, MD 20715 | $75K |
| JAMES L. CHEN, M.D. EIN 45-5051429 NONE | Other services; Direct payment from the plan Service code 49 | — | $71K |
| PERRY ORTHOPEDICS & SPORTS MEDICINE EIN 56-2258322 NONE | Direct payment from the plan; Other services Service code 49 | — | $68K |
| D.C. DELIS CLINICAL PSYCHOLOGIST EIN 81-0608729 NONE | Direct payment from the plan; Other services Service code 49 | — | $68K |
| RAYMOND FABER NONE | Other services; Direct payment from the plan Service code 49 | 11703 HUEBNER ROAD SUITE 106-273 SAN ANTONIO, TX 78230 | $65K |
| RODNEY D. VANDERPLOEG, PH.D. NONE | Direct payment from the plan; Other services Service code 49 | 5322 PRIMROSE LAKE CIRCLE SUITE G TAMPA, FL 33647 | $64K |
| CENTER FOR ATHELETIC MEDICINE, LTD EIN 36-3815402 NONE | Other services; Direct payment from the plan Service code 49 | — | $63K |
| JONATHAN SCHLEIMER, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 9850 GENESEE AVENUE #750 LA JOLLA, CA 92037 | $61K |
| ORTHOPAEDIC ASSOCIATION OF CHICAGO EIN 36-2731428 NONE | Other services; Direct payment from the plan Service code 49 | — | $60K |
| SAN DIEGO SPORTS MEDICINE & ORTHO EIN 33-0834309 NONE | Direct payment from the plan; Other services Service code 49 | — | $59K |
| ROBERT A. BORNSTEIN, PH.D. NONE | Direct payment from the plan; Other services Service code 49 | 370 W. 9TH AVE ROOM 237 COLUMBUS, OH 43210 | $58K |
| JOSEPH D. EUBANKS, PH.D. NONE | Other services; Direct payment from the plan Service code 49 | 5101 MEDICAL DRIVE SAN ANTONIO, TX 78229 | $54K |
| HEDLEY ORTHOPEDIC INSTITUTE NONE | Direct payment from the plan; Other services Service code 49 | 2122 E. HIGHLAND AVE SUITE 300 PHOENIX, AZ 85016 | $52K |
| MARC F. SCHLOSBERG, M.D. EIN 52-2056886 NONE | Direct payment from the plan; Other services Service code 49 | — | $51K |
| TERRY L. THOMPSON, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 3227 LIVINGSTON STREET NW WASHINGTON, DC 20015 | $51K |
| FRANCISCO I. PEREZ, PH.D. EIN 74-2178016 NONE | Other services; Direct payment from the plan Service code 49 | — | $50K |
| OSU NEUROSCIENCE CENTER, LLC EIN 31-1466115 NONE | Direct payment from the plan; Other services Service code 49 | — | $48K |
| GREGORY MACK, M.D. EIN 20-4015690 NONE | Other services; Direct payment from the plan Service code 49 | — | $42K |
| THE BANK OF NY MELLON EIN 13-5160382 NONE | Custodial (securities); Direct payment from the plan; Investment management fees paid directly by plan; Investment management Service code 19 | — | $41K |
| DENVER VEIL ORTHOPEDICS, P.C. EIN 84-1548304 NONE | Direct payment from the plan; Other services Service code 49 | — | $39K |
| NATIONAL REHABILITATION HOSPITAL EIN 52-1369749 NONE | Other services; Direct payment from the plan Service code 49 | — | $39K |
| GLENN PERRY, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 2826 RANDOLPH ROAD CHARLOTTE, NC 28211 | $37K |
| WAYNE GORDON, PH.D. NONE | Other services; Direct payment from the plan Service code 49 | 5 EAST 98TH STREET BOX 1240B NEW YORK, NY 10029 | $37K |
| MARILYN KREIBEL EIN 33-0098491 NONE | Other services; Direct payment from the plan Service code 49 | — | $36K |
| CHARLES A. BUSH-JOSEPH, MD NONE | Direct payment from the plan; Other services Service code 49 | 419 N. LINCOLN HINSDALE, IL 60521 | $34K |
| CHICAGO PSYCHIATRY ASSOCIATES EIN 46-5610304 NONE | Direct payment from the plan; Other services Service code 49 | — | $34K |
| OSU WEXNER MEDICAL CENTER EIN 31-1322867 NONE | Direct payment from the plan; Other services Service code 49 | — | $32K |
| EDWARD A. RANKIN, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 1160 VARNUM STREET NE SUITE 312 WASHINGTON, DC 20017 | $31K |
| PCA, LLC EIN 26-2502340 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $28K |
| OSU HARDING HOSPITAL EIN 31-1340739 NONE | Other services; Direct payment from the plan Service code 49 | — | $23K |
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 | 2,220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,690 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5,506 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,416 | 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.