| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS | PO BOX 5817 WALLINGFORD, CT 06492 | UNION LABOR LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAV-RX EIN 47-0527013 NONE | Claims processing Service code 12 | 224 NORTH PARK AVENUE FREMONT, NE 06492 | $502K |
| ZENITH AMERICAN SOLUTIONS INC EIN 06-0811449 NONE | Accounting (including auditing); Claims processing Service code 10 | 10 TECHNOLOGY DRIVE WALLINGFORD, CT 06492 | $79K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Consulting (general) Service code 16 | 116 HUNTINGTON AVE, 8TH FLOOR BOSTON, MA 02116 | $21K |
| BEERS, HAMERMAN, COHEN & BURGER PC EIN 47-2517893 NONE | Accounting (including auditing) Service code 10 | 234 CHURCH STREET NEW HAVEN, CT 06510 | $19K |
| SEGAL SELECT INVESTMENTS EIN 13-2646110 NONE | Insurance brokerage commissions and fees Service code 53 | 333 WEST 34TH STREET 2ND FLORR NEW YORK, NY 10001 | $13K |
| HOLM OHARA EIN 13-3591118 NONE | Legal Service code 29 | 3 WEST 35TH STREET, 9TH FLOOR NEW YORK, NY 10001 | $13K |
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 | 255 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 255 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS, INC. | 436 | $125K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | UNION LABOR LIFE INSURANCE COMPANY | 436 | $682K |
| Other | UNION LABOR LIFE INSURANCE COMPANY | 235 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.