| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMP (EASTERN STATES),INC | — | THE UNION LABOR LIFE INSURANCE COMPANY | $6K | — | $6K | 1.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 NONE | Direct payment from the plan; Other services; Contract Administrator; Participant communication; Non-monetary compensation; Claims processing Service code 12 | — | $3.4M |
| EXPRESS SCRIPTS, INC EIN 43-1420563 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $2.1M |
| DELTA DENTAL OF MA EIN 04-6143185 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $682K |
| HMC HEALTHWORKS INC. NONE | Claims processing; Direct payment from the plan Service code 12 | 2 PARK PLAZA, SUITE 1200 IRVINE, CA 92614 | $421K |
| THE SEGAL CO (EASTERN STATES), INC EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $414K |
| CMIT SOLUTIONS EIN 27-0903009 NONE | Direct payment from the plan; Other services Service code 49 | — | $201K |
| EMPLOYEE A EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $177K |
| SEGAL ROITMAN, LLP EIN 04-2489114 NONE | Legal; Direct payment from the plan Service code 29 | — | $163K |
| BRIDGEWAY BENEFIT TECHNOLOGIES LLC EIN 52-1796473 NONE | Direct payment from the plan; Other services Service code 49 | — | $154K |
| EMPLOYEE B EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $124K |
| EMPLOYEE C EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $120K |
| EMPLOYEE D EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $117K |
| EMPLOYEE E EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $115K |
| EMPLOYEE F EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $115K |
| EMPLOYEE G EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $115K |
| SCHULTHEIS & PANETTIERI LLP EIN 13-1577780 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $113K |
| EMPLOYEE H EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $108K |
| EMPLOYEE I EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $104K |
| EMPLOYEE J EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $99K |
| EMPLOYEE K EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $98K |
| 617 MEDIA GROUP EIN 90-1252805 NONE | Direct payment from the plan; Other services Service code 49 | — | $94K |
| STATE STREET GLOBAL ADVISORS EIN 81-4017137 NONE | Custodial (securities); Investment management; Custodial (other than securities); Other fees; Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 18 | — | $83K |
| EMPLOYEE L EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $80K |
| EMPLOYEE M EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| EMPLOYEE N EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| EMPLOYEE O EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| EMPLOYEE P EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $78K |
| CORRENTE LAW CORPORATION EIN 06-1484539 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $78K |
| O'REILLY, GROSSO, GROSS & JONES, PC EIN 04-3318596 NONE | Legal; Direct payment from the plan Service code 29 | — | $78K |
| EMPLOYEE Q EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $76K |
| EMPLOYEE R EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $75K |
| EMPLOYEE S EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| EMPLOYEE T EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $69K |
| STATE STREET BANK & TRUST CO. EIN 04-1867445 NONE | Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Other fees; Distribution (12b-1) fees; Custodial (securities); Float revenue; Investment management Service code 19 | — | $66K |
| LOOMIS SAYLES & COMPANY EIN 04-3200030 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $64K |
| EMPLOYEE U EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $64K |
| EMPLOYEE V EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $61K |
| EMPLOYEE W EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $58K |
| EMPLOYEE X EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $55K |
| EMPLOYEE Y EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| TELLIGEN INC EIN 42-0992483 NONE | Direct payment from the plan; Other services Service code 49 | — | $51K |
| DAVIS VISION EIN 11-3051991 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $51K |
| EMPLOYEE Z EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $46K |
| EMPLOYEE AA EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $45K |
| EMPLOYEE AB EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $44K |
| EMPLOYEE AC EIN 04-2214296 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $40K |
| EMPLOYEE AD EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $39K |
| EMPLOYEE AE EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $39K |
| EMPLOYEE AF EIN 04-2214296 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $33K |
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 | 11,214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 65 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,279 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 10,397 | $313K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 10,852 | $462K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 10,397 | $313K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,852 | — |
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."
No prospect flags tripped on this filing.