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 | Direct payment from the plan; Other services Service code 49 | — | $8.2M |
| GROOM LAW GROUP EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $2.9M |
| ATLANTA NEUROPSYCHOLOGY, LLC EIN 46-1232782 NONE | Direct payment from the plan; Other services Service code 49 | — | $271K |
| KEVIN KESSLER, M.D., P.A. EIN 20-1388210 NONE | Other services; Direct payment from the plan Service code 49 | — | $243K |
| 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 | $237K |
| DAVID F. APPLE JR., M.D. NONE | Direct payment from the plan; Other services Service code 49 | 2020 PEACHTREE ROAD NW ATLANTA, GA 30309 | $234K |
| DEAN C. DELIS, CLINICAL PSYCH., INC EIN 81-0608729 NONE | Other services; Direct payment from the plan Service code 49 | — | $226K |
| JAMES L. CHEN, M.D., INC. EIN 45-5051429 NONE | Other services; Direct payment from the plan Service code 49 | — | $223K |
| ALL FLORIDA ORTHOPAEDIC ASSOCIATES EIN 59-2681990 NONE | Other services; Direct payment from the plan Service code 49 | — | $223K |
| BARRY J. MCCASLAND, M.D., P.C. EIN 58-1318583 NONE | Other services; Direct payment from the plan Service code 49 | — | $214K |
| JANYNA MERCADO, PH.D. NONE | Other services; Direct payment from the plan Service code 49 | 19430 CAMINO RIDGE SAN ANTONIO, TX 78258 | $213K |
| PSYCHIATRIC ASSOC. OF ATLANTA, LLC EIN 01-0683990 NONE | Direct payment from the plan; Other services Service code 49 | — | $206K |
| ERIC J. BRAHIN, M.D., PLLC EIN 46-4435141 NONE | Direct payment from the plan; Other services Service code 49 | — | $203K |
| SAN DIEGO SPORTS MEDICINE & ORTHO. EIN 33-0834309 NONE | Other services; Direct payment from the plan Service code 49 | — | $202K |
| PEACHTREE ORTHOPEDIC CLINIC EIN 58-1080740 NONE | Direct payment from the plan; Other services Service code 49 | — | $186K |
| WILLIAM GARMOE, PH.D. NONE | Other services; Direct payment from the plan Service code 49 | 14300 GALLANT FOX LANE SUITE 107 BOWIE, MD 20715 | $185K |
| RODNEY D. VANDERPLOEG, PH.D. NONE | Direct payment from the plan; Other services Service code 49 | 111 2ND AVENUE NE SUITE 322 SAINT PETERSBURG, FL 33701 | $162K |
| F. HARLAN SELESNICK, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 7501 SW 104TH STREET MIAMI, FL 33156 | $162K |
| VIRGIL MEDLOCK III, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 4408 LIVINGSTON AVE DALLAS, TX 75205 | $156K |
| PREM PARMAR, M.D. EIN 33-1010142 NONE | Direct payment from the plan; Other services Service code 49 | — | $139K |
| RAYMOND FABER, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 11703 HUEBNER ROAD SUITE 106-273 SAN ANTONIO, TX 78230 | $130K |
| FONDREN ORTHOPEDIC GROUP, LLP EIN 76-0363583 NONE | Other services; Direct payment from the plan Service code 49 | — | $129K |
| NICOLE WERNER, PH.D., LLC EIN 81-4319319 NONE | Other services; Direct payment from the plan Service code 49 | — | $126K |
| ORTHOPEDIC CENTERS OF COLORADO EIN 47-5021191 NONE | Other services; Direct payment from the plan Service code 49 | — | $126K |
| FLORIDA SPORTS INJURY EIN 45-2806834 NONE | Direct payment from the plan; Other services Service code 49 | — | $126K |
| PRESTON WOLIN, M.D. EIN 36-3815402 NONE | Other services; Direct payment from the plan Service code 49 | — | $125K |
| ROBERT A. BORNSTEIN, PH.D. NONE | Direct payment from the plan; Other services Service code 49 | 495 TUCKER DRIVE WORTHINGTON, OH 43085 | $124K |
| AAKASH SHAH NONE | Direct payment from the plan; Other services Service code 49 | 5701 WEST 119TH STREET SUITE 308 OVERLAND PARK, KS 66209 | $113K |
| AON EIN 22-2232264 NONE | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | — | $110K |
| DOYLE PATTON, PH.D. EIN 20-2000235 NONE | Other services; Direct payment from the plan Service code 49 | — | $108K |
| JOSEPH CHAD HOYLE, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 4166 BRYSON COVE CIRCLE DUBLIN, OH 43016 | $108K |
| NEAL DEUTCH, PH.D. & ASSOCIATES EIN 48-1122260 NONE | Direct payment from the plan; Other services Service code 49 | — | $103K |
| UNIVERSITY PHYSICIANS, INC. EIN 74-2161737 NONE | Other services; Direct payment from the plan Service code 49 | — | $100K |
| ORTHOPAEDIC CARE SPECIALISTS EIN 65-0882367 NONE | Direct payment from the plan; Other services Service code 49 | — | $100K |
| STEPHEN M. SERGAY, M.D. EIN 83-3787991 NONE | Other services; Direct payment from the plan Service code 49 | — | $100K |
| RR DONNELLEY RECEIVABLES, INC. EIN 52-2125127 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $99K |
| GREGORY MACK, M.D., INC. EIN 20-4015690 NONE | Direct payment from the plan; Other services Service code 49 | — | $99K |
| HERTZ CORPORATION EIN 13-1938568 NONE | Direct payment from the plan; Other services Service code 49 | — | $94K |
| PAUL S. SAENZ, D.O., P.A. EIN 74-2613458 NONE | Other services; Direct payment from the plan Service code 49 | — | $92K |
| STEPHEN MACCIOCCHI, PH.D. NONE | Direct payment from the plan; Other services Service code 49 | P.O. BOX 189 MARBLE HILL, GA 30148 | $90K |
| KRIEBEL & ASSOCIATES EIN 47-5477044 NONE | Other services; Direct payment from the plan Service code 49 | — | $90K |
| MARK JORDAN TULLMAN, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 20 FRONTENAC ESTATES DRIVE FRONTENAC, MO 63131 | $82K |
| LAURA LACRITZ, PH.D. EIN 75-6002868 NONE | Other services; Direct payment from the plan Service code 49 | — | $75K |
| OSU SPORTS MEDICINE CENTER EIN 31-1322867 NONE | Direct payment from the plan; Other services Service code 49 | — | $74K |
| DAVID F. CLARK, M.D. EIN 83-1863071 NONE | Direct payment from the plan; Other services Service code 49 | — | $72K |
| MENORAH MEDICAL GROUP, LLC EIN 80-0609778 NONE | Direct payment from the plan; Other services Service code 49 | — | $71K |
| ROBERT L HEILBRONNER, PH.D. NONE | Direct payment from the plan; Other services Service code 49 | 333 N. MICHIGAN AVENUE SUITE 1801 CHICAGO, IL 60601 | $70K |
| STEVEN EPSTEIN, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 2115 WISCONSIN AVENUE NW SUITE 200 WASHINGTON, DC 20007 | $68K |
| VHS OUTPATIENT CLINICS, INC. EIN 62-1816823 NONE | Direct payment from the plan; Other services Service code 49 | — | $67K |
| ALAN BREEN, PH.D., LLC EIN 81-1924765 NONE | Direct payment from the plan; Other services Service code 49 | — | $65K |
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 | 2,292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,247 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6,860 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 11,399 | 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.