| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 333 WEST 34TH STREET NEW YORK, NY 10001 | THE UNION LABOR LIFE INSURANCE COMPANY | $58K | — | $58K | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator; Direct payment from the plan Service code 13 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $601K |
| ROSALBA PEREZ EIN 13-1564856 PLAN ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $178K |
| SLEVIN & HART P.C. EIN 52-1708613 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 1625 MASSACHUSETTS AVE NW, STE 450 WASHINGTON, DC 20036 | $131K |
| MARSHALL PARIS EIN 13-6367793 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $95K |
| RAMONA AYBAR EIN 13-6367793 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $77K |
| JOU ZOQUIER EIN 13-6367793 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $74K |
| FLORMARIA TOULSON EIN 13-1564856 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $74K |
| LOURDES LANZOT EIN 13-6367793 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $69K |
| VEDWATIE PRASAD EIN 13-1564856 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $68K |
| PIERRE J. BOUTIN EIN 13-1564856 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $64K |
| JEAN EDY JOSEPH EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $58K |
| LOUVINIA GREENAWAY EIN 13-1564856 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $52K |
| NELSY RODRIGUEZ EIN 13-1564856 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 475 MARKET STREET, SUITE 307 ELMWOOD PARK, NJ 07407 | $42K |
| UNITED HEALTHCARE INSURANCE CO. EIN 36-2739571 CONTRACT ADMINISTRATOR | Contract Administrator; Direct payment from the plan Service code 13 | 185 ASYLUM STREET HARTFORD, CT 06103 | $38K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $30K |
| CVS PHARMACY, INC EIN 05-0340626 CLAIMS PROCESSING | Claims processing; Direct payment from the plan Service code 12 | 180 PASSAIC AVE FAIRFIELD, NJ 07004 | $29K |
| VISION SCREENING EIN 11-2358021 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | 1919 MIDDLE COUNTRY ROAD, SUITE 304 CENTEREACH, NY 11720 | $27K |
| BOSTON TRUST & INVESMENT MANAGEMENT EIN 04-2273811 INVESTMENT MANAGER | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Investment management; Trustee (directed); Trustee (discretionary) Service code 21 | ONE BEACON STREET BOSTON, MA 02108 | $22K |
| THE SEGAL COMPANY, INC. EIN 13-1835864 ACTUARIAL | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | 333 WEST 34TH STREET NEW YORK, NY 10001 | $21K |
| NEPC, LLC EIN 26-1429809 INVESTMENT ADVISORY | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | 255 STATE STREET BOSTON, MA 02109 | $10K |
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 | 2,070 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,070 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 2 carriers) | DENTCARE DELIVERY SYSTEMS | 1,470 | $419K |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 2,070 | $102K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 2,070 | $972K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,070 | — |
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.