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 |
|---|---|---|---|
| TOTAL PLAN CONCEPTS EIN 45-4564412 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | 571 MCDONALD AVE BROOKLYN, NY 11218 | $804K |
| SMITH RX PRESCIPTION DRUG VENDOR | Other services Service code 49 | 300 BRANNAN STREET SUITE 601 SAN FRANCISCO, CA 94107 | $78K |
| CENTERS FOR SPECIALTY CARE EIN 74-3126038 RECORDKEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing) Service code 10 | 4770 WHITE PLAINS RD BRONX, NY 10470 | $49K |
| FASTEN HALBERSTAM LLP EIN 47-2319109 AUDIT FIRM | Accounting (including auditing) Service code 10 | 40 WALL STREET SUITE 3602 NEW YORK, NY 10005 | $14K |
| ROBINSON & COLE LLP EIN 06-0512640 ATTORNEY | Accounting (including auditing) Service code 10 | 280 TRUMBULL STREET HARTFORD, CT 06103 | $8K |
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 | 2,633 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 53 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,686 | 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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.