| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY | 30 WATERSIDE DRIVE SUITE 300 FARMINGTON, CT 060323069 | THE UNION LABOR LIFE INSURANCE COMPANY | $10K | — | $10K | 0.81% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL RX, INC. EIN 35-2612946 PHARMACY BENEFIT MANAGER | Claims processing; Direct payment from the plan Service code 12 | — | $4.9M |
| CT PIPE TRADES BENEFIT FUNDS ADMIN EIN 06-1542648 ADMINISTRATIVE CORP | Plan Administrator Service code 14 | — | $996K |
| ANTHEM HEALTH PLANS EIN 06-1475928 BENEFIT PROVIDER | Other commissions; Float revenue; Insurance agents and brokers; Claims processing; Insurance brokerage commissions and fees; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $533K |
| SEGAL COMPANY EIN 13-1928058 ACTUARIAL CONSULTANT | Consulting (pension) Service code 17 | — | $116K |
| DAVIS VISION EIN 11-3051991 VISION BENEFIT PROVIDER | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $101K |
| HOLM & O'HARA LLP EIN 13-3591118 ATTORNEY | Legal Service code 29 | — | $99K |
| SEI EIN 23-1707341 INVESTMENT CUSTODIAN | Investment management fees paid indirectly by plan; Trustee (bank, trust company, or similar financial institution); Custodial (securities); Float revenue; Trustee (directed); Investment management Service code 19 | — | $81K |
| SEGAL SELECT INSURANCE SERVICES, IN EIN 46-0619194 INSURANCE PROVIDER | Insurance brokerage commissions and fees Service code 53 | — | $39K |
| LOWER HUDSON VALLEY E.A.P. EIN 13-3240307 HEALTH CONSULTANTS | Other fees Service code 99 | — | $39K |
| BEERS, HAMERMAN, COHEN & BURGER, PC EIN 47-2517893 AUDITOR | Accounting (including auditing) Service code 10 | — | $29K |
| ROBERT M. CHEVERIE & ASSOCIATES EIN 06-1335139 ATTORNEY | Legal Service code 29 | — | $28K |
| INNOVATIVE SOFTWARE SOLUTIONS EIN 23-2182079 COMPUTER SUPPORT CONSUL | Other fees Service code 99 | — | $26K |
| MAGNANI GRAPHICS EIN 83-0345189 PRINTING SERVICES | Other fees Service code 99 | — | $17K |
| NOVAK FRANCELLA LLC EIN 61-1436956 PAYROLL AUDITOR | Accounting (including auditing) Service code 10 | — | $10K |
| GDIT MEDICARE COB BENEFIT PROVIDER | Other fees Service code 99 | PO BOX 829968 PHILADELPHIA, PA 19182 | $6K |
| UCONN EIN 06-0772160 HEARING BENEFIT PROVIDER | Other fees Service code 99 | — | $6K |
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 | 1,257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 732 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,989 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ANTHEM HEALTH PLANS, INC. | 1,232 | $0 |
| Life insurance(2 contracts, 2 carriers) | SYMETRA | 1,794 | $112K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,394 | $1.2M |
| Other(2 contracts, 2 carriers) | UNION LABOR LIFE INSURANCE, LLC | 1,794 | $317K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,794 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.