| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY | 333 WEST 34TH STREET NEW YORK, NY 10001 | UNION LABOR LIFE INSURANCE COMPANY | $6K | $6K | $12K | 2.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAV-RX EIN 47-0527013 NONE | Claims processing; Direct payment from the plan Service code 12 | 224 NORTH PARK AVENUE FREEMONT, NE 68025 | $1.5M |
| LABOR FIRST LLC NONE | Other fees Service code 99 | 3000 MIDLANTIC DRIVE, STE. 101 MT. LAUREL, NJ 08054 | $519K |
| ZENITH AMERICAN EIN 52-1590516 NONE | Claims processing; Accounting (including auditing) Service code 10 | PO BOX 5817 WALLINGFORD, CT 06492 | $331K |
| HARTFORD LIFE INSURANCE NONE | Other insurance fees and expenses Service code 73 | 690 ASYLUM AVENUE HARTFORD, CT 06155 | $107K |
| ZELIS CLAIMS INTEGRITY NONE | Other fees Service code 99 | 2 CROSSROADS DR BEDMINSTER, NJ 07921 | $105K |
| DAVIS VISION EIN 11-3051991 NONE | Other insurance fees and expenses Service code 73 | 159 EXPRESS STREET PLAINVIEW, NY 11803 | $93K |
| SEGAL COMPANY EIN 13-1835864 NONE | Actuarial Service code 11 | 116 HUNTINGTON AVE, 8TH FLOOR BOSTON, MA 02116 | $46K |
| ROBERT M. CHEVERIE & ASSOCIATES P.C EIN 06-1335139 NONE | Legal Service code 29 | 333 EAST RIVER DRIVE, SUITE 101 EAST HARTFORD, CT 06108 | $40K |
| BEERS HAMERMAN COHEN & BURGER PC EIN 47-2517893 NONE | Accounting (including auditing) Service code 10 | 234 CHURCH STREET NEW HAVEN, CT 06510 | $20K |
| BRADLEY, FOSTER, & SARGENT NONE | Investment management Service code 28 | CITY PLACE II, 185 ASYLUM ST HARTFORD, CT 06103 | $18K |
| LOWER HUDSON VALLEY E.A.P. EIN 13-3240307 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 3505 HILL BLVD. SUITE A YORKTOWN HEIGHTS, NY 10598 | $16K |
| CT COALITION OF TAFT HARTLEY PLANS NONE | Other services Service code 49 | 942 MAIN STREET HARTFORD, CT 06123 | $13K |
| EPIC NONE | Claims processing Service code 12 | — | $12K |
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 | 365 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 233 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 598 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS, INC. | 641 | $0 |
| Dental | ANTHEM HEALTH PLANS, INC. | 641 | $0 |
| Stop-loss / reinsurancereinsurance | UNION LABOR LIFE INSURANCE COMPANY | 413 | $401K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 641 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.