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 | — | $4.9M |
| GROOM LAW GROUP, CHARTERED EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $4.5M |
| AON EIN 22-2232264 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $395K |
| BARRY J. MCCASLAND, M.D., P.C. EIN 58-1318583 NONE | Direct payment from the plan; Other services Service code 49 | — | $373K |
| THOMAS G. BURNS, PSY.D., ABPP-CN EIN 58-2262050 NONE | Direct payment from the plan; Other services Service code 49 | — | $333K |
| ERIC J. BRAHIN, M.D., PLLC EIN 46-4435141 NONE | Other services; Direct payment from the plan Service code 49 | — | $324K |
| ERNEST FUNG, PH.D EIN 83-1448865 NONE | Direct payment from the plan; Other services Service code 49 | — | $306K |
| DEAN C. DELIS, CLINICAL PSYCH., INC EIN 81-0608729 NONE | Other services; Direct payment from the plan Service code 49 | — | $302K |
| NICOLE WERNER, PH.D., LLC EIN 81-4319319 NONE | Other services; Direct payment from the plan Service code 49 | — | $288K |
| DOUGLAS B. COOPER, PH.D., ABPP-CN EIN 45-4281320 NONE | Direct payment from the plan; Other services Service code 49 | — | $262K |
| JUSTIN JF O'ROURKE, PH.D. ABPP-CN EIN 47-4516870 NONE | Other services; Direct payment from the plan Service code 49 | — | $258K |
| ALL FLORIDA ORTHOPAEDIC ASSOCIATES EIN 59-2681990 NONE | Other services; Direct payment from the plan Service code 49 | — | $224K |
| SOUTH BROWARD HOSPITAL DISTRICT EIN 59-6014973 NONE | Other services; Direct payment from the plan Service code 49 | — | $211K |
| PEACHTREE ORTHOPEDIC CLINIC EIN 58-1080740 NONE | Direct payment from the plan; Other services Service code 49 | — | $192K |
| MARK JORDAN TULLMAN, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 20 FRONTENAC ESTATES DRIVE FRONTENAC, MO 63131 | $183K |
| JOHN RABUN, M.D., LLC EIN 45-2529046 NONE | Other services; Direct payment from the plan Service code 49 | — | $177K |
| RODNEY D. VANDERPLOEG, PH.D. NONE | Other services; Direct payment from the plan Service code 49 | 111 2ND AVENUE NE SUITE 322 SAINT PETERSBURG, FL 33701 | $177K |
| KATHERINE BRIGGS BROWNLOWE, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 2121 YORKSHIRE ROAD UPPER ARLINGTON, OH 43221 | $171K |
| THOMAS A. CRUM, PH.D., ABPP, PA EIN 85-1249763 NONE | Direct payment from the plan; Other services Service code 49 | — | $168K |
| CHARLENE BANG, PSYD NONE | Other services; Direct payment from the plan Service code 49 | 34-21 78TH STREET #2B JACKSON HEIGHTS, NY 11372 | $166K |
| LAURA DESADIER, D.O. EIN 47-3033331 NONE | Other services; Direct payment from the plan Service code 49 | — | $166K |
| LAUREN DRAG, PH.D EIN 82-0726006 NONE | Direct payment from the plan; Other services Service code 49 | — | $163K |
| ROBERT L HEILBRONNER, PH.D. NONE | Other services; Direct payment from the plan Service code 49 | 333 N. MICHIGAN AVENUE SUITE 1828 CHICAGO, IL 60601 | $158K |
| 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 | $154K |
| KEVIN KESSLER, M.D., P.A. EIN 20-1388210 NONE | Direct payment from the plan; Other services Service code 49 | — | $147K |
| F. HARLAN SELESNICK, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 13101 S. DIXIE HIGHWAY SUITE 400 PINECREST, FL 33156 | $147K |
| NEAL DEUTCH, PH.D. & ASSOCIATES EIN 48-1122260 NONE | Direct payment from the plan; Other services Service code 49 | — | $142K |
| MARTIN STRASSNIG, M.D. EIN 81-3867574 NONE | Other services; Direct payment from the plan Service code 49 | — | $142K |
| FONDREN ORTHOPEDIC GROUP, LLP EIN 76-0363583 NONE | Other services; Direct payment from the plan Service code 49 | — | $140K |
| PERRY ORTHO & SPORTS MEDICINE, P.A. EIN 56-2258322 NONE | Other services; Direct payment from the plan Service code 49 | — | $139K |
| ANNETTE OKAI, P.A. EIN 45-5235337 NONE | Other services; Direct payment from the plan Service code 49 | — | $138K |
| LAURA LACRITZ, PH.D. EIN 75-6002868 NONE | Other services; Direct payment from the plan Service code 49 | — | $136K |
| UNIVERSITY PHYSICIANS, INC. EIN 74-2161737 NONE | Other services; Direct payment from the plan Service code 49 | — | $133K |
| VHS OUTPATIENT CLINICS, INC. EIN 62-1816823 NONE | Direct payment from the plan; Other services Service code 49 | — | $132K |
| OSU PSYCHIATRY, LLC EIN 20-0437235 NONE | Direct payment from the plan; Other services Service code 49 | — | $130K |
| WILLIAM GARMOE, PH.D. NONE | Other services; Direct payment from the plan Service code 49 | 14300 GALLANT FOX LANE SUITE 107 BOWIE, MD 20715 | $130K |
| FLORIDA SPORTS INJURY EIN 45-2806834 NONE | Direct payment from the plan; Other services Service code 49 | — | $129K |
| VIRGIL MEDLOCK III, M.D. NONE | Other services; Direct payment from the plan Service code 49 | 4408 LIVINGSTON AVE DALLAS, TX 75205 | $124K |
| MATTHEW W. NORMAN, M.D., LLC EIN 20-0332027 NONE | Other services; Direct payment from the plan Service code 49 | — | $124K |
| 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 |
| RR DONNELLEY RECEIVABLES, INC. EIN 52-2125127 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $119K |
| PREM PARMAR, M.D. EIN 33-1010142 NONE | Other services; Direct payment from the plan Service code 49 | — | $116K |
| MICHAEL LARDON, M.D. NONE | Direct payment from the plan; Other services Service code 49 | 3750 CONVOY STREET #318 SAN DIEGO, CA 92111 | $114K |
| HERTZ CORPORATION EIN 13-1938568 NONE | Other services; Direct payment from the plan Service code 49 | — | $114K |
| GEORGE J. DEMAKIS, PH.D. EIN 81-1390308 NONE | Other services; Direct payment from the plan Service code 49 | — | $109K |
| OSU NEUROSCIENCE CENTER, LLC EIN 31-1466115 NONE | Direct payment from the plan; Other services Service code 49 | — | $106K |
| KRIEBEL & ASSOCIATES EIN 47-5477044 NONE | Other services; Direct payment from the plan Service code 49 | — | $102K |
| ORTHOPEDIC CENTERS OF COLORADO EIN 47-5021191 NONE | Other services; Direct payment from the plan Service code 49 | — | $99K |
| SELENA ELLIS, M.D. EIN 20-2631373 NONE | Direct payment from the plan; Other services Service code 49 | — | $95K |
| 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 | $94K |
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 | 2,819 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,713 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7,110 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 12,642 | 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.