| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY | 333 WEST 34TH STREET NEW YORK, NY 10001 | THE UNION LABOR LIFE INSURANCE COMPANY | $10K | — | $10K | 1.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL RX, INC. EIN 35-2612946 PHARMACY BENEFIT MANAGER | Claims processing; Direct payment from the plan Service code 12 | — | $5.5M |
| CT PIPE TRADES BENEFIT FUNDS ADMIN EIN 06-1542648 ADMINISTRATIVE CORP | Plan Administrator Service code 14 | — | $983K |
| EYEMED VISION BENEFIT PROVIDER | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | 4000 LUXOTTICA PL MASON, OH 45040 | $159K |
| SEGAL COMPANY EIN 13-1928058 ACTUARIAL CONSULTANT | Consulting (pension) Service code 17 | — | $118K |
| HOLM & O'HARA LLP EIN 13-3591118 ATTORNEY | Legal Service code 29 | — | $90K |
| CT COALITION OF TAFT-HARTLEY FUNDS EIN 22-3176650 SUPPORT SERVICES | Other fees Service code 99 | — | $75K |
| SEI EIN 23-1707341 INVESTMENT CUSTODIAN | Investment management fees paid indirectly by plan; Custodial (securities); Trustee (bank, trust company, or similar financial institution); Float revenue; Trustee (directed); Investment management Service code 19 | — | $71K |
| LOWER HUDSON VALLEY E.A.P. EIN 13-3240307 HEALTH CONSULTANTS | Other fees Service code 99 | — | $54K |
| SEGAL SELECT INSURANCE SERVICES, IN EIN 46-0619194 INSURANCE PROVIDER | Insurance brokerage commissions and fees Service code 53 | — | $41K |
| SCANOPTICS LLC SCANNING SERVICES | Other fees Service code 99 | 169 PROGRESS DRIVE MANCHESTER, NH 06042 | $34K |
| BRIDGEWAY BENEFITS TECHNOLOGIES EIN 52-1796473 COMPUTER SUPPORT CONSUL | Consulting (general); Direct payment from the plan Service code 16 | — | $33K |
| 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 |
| NOVAK FRANCELLA LLC EIN 61-1436956 PAYROLL AUDITOR | Accounting (including auditing) Service code 10 | — | $24K |
| DAVIS VISION EIN 11-3051991 VISION BENEFIT PROVIDER | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $19K |
| MAGNANI GRAPHICS EIN 83-0345189 PRINTING SERVICES | Other fees Service code 99 | — | $19K |
| UNION PRINTING PRINTING SERVICES | Other fees Service code 99 | 45 WESTRIDGE DRIVE WATERBURY, CT 06708 | $17K |
| CONTEXT4 HEALTHCARE EIN 27-0386030 HEALTH BENEFIT CONSULTANT | Other fees Service code 99 | — | $7K |
| UCONN EIN 06-0772160 HEARING BENEFIT PROVIDER | Other fees Service code 99 | — | $6K |
| ANTHEM HEALTH PLANS EIN 06-1475928 BENEFIT PROVIDER | Insurance agents and brokers; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Insurance brokerage commissions and fees; Claims processing; Other commissions; Contract Administrator; Float revenue Service code 12 | — | $0 |
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 | 1,319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 730 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,049 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ANTHEM HEALTH PLANS, INC. | 1,285 | $0 |
| Life insurance | SYMETRA | 1,840 | $348K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,452 | $987K |
| Other | SYMETRA | 1,840 | $348K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,840 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.