| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMPANY, INC. | 333 WEST 34TH STREET NEW YORK, NY 10001 | EVEREST REINSURANCE COMPANY | $15K | — | $15K | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 CLAIMS PROCESSING | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other services; Contract Administrator Service code 12 | 165 BROADWAY NEW YORK, NY 10006 | $475K |
| MAGNACARE ADMINISTRATIVE SERVICES EIN 11-3410766 CLAIMS PROCESSING | Claims processing; Direct payment from the plan Service code 12 | 1600 STEWART AVENUE 7TH FLOOR WESTBURY, NY 11590 | $158K |
| JACINTO FRAGOSO EIN 13-1737041 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 140 BROADWAY HAWTHORNE, NY 10532 | $128K |
| TOCQUEVILLE ASSET MANAGEMENT LP EIN 13-3547557 INVESTMENT MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | 40 WEST 57TH STREET 19TH FLOOR NEW YORK, NY 10019 | $102K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 LEGAL | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $94K |
| CHRISTINE COSTA EIN 13-1737041 PLAN ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | 140 BROADWAY HAWTHORNE, NY 10532 | $79K |
| THE SEGAL COMPANY, INC. EIN 13-1835864 ACTUARY | Direct payment from the plan; Actuarial Service code 11 | 333 WEST 34TH STREET NEW YORK, NY 10001 | $52K |
| WAGNER & ZWERMAN LLP EIN 11-2836481 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 450 WIRELESS BLVD HAUPPAUGE, NY 11788 | $45K |
| ROSI GOLDBERG EIN 13-1737041 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 140 BROADWAY HAWTHORNE, NY 10532 | $45K |
| TPA COMPUTER EIN 13-3329882 COMPUTER CONSULTANT | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Direct payment from the plan Service code 15 | 531 ROUTE 52 CARMEL, NY 10512 | $41K |
| CLARITY TESTING SERVICES EIN 13-3869722 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | 150 WHITE PLAINS ROAD SUITE 204 TARRYTOWN, NY 10591 | $38K |
| JASMINE SANCHEZ EIN 13-1737041 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 140 BROADWAY HAWTORNE, NY 10532 | $28K |
| MICHELLE FERNANDES EIN 13-1737041 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 140 BROADWAY HAWTHORNE, NY 10532 | $27K |
| PAMELA MENDE EIN 13-1737041 MEDICAL CONSULTANT | Consulting (general); Direct payment from the plan; Consulting fees Service code 16 | 140 BROADWAY HAWTHORNE, NY 10532 | $20K |
| THEODOR H. BROWN DDS EIN 13-3043628 DENTAL CONSULTANT | Consulting (general); Consulting fees; Direct payment from the plan Service code 16 | 358 NORTH BROADWAY SUITE 201 SLEEPY HOLLOW, NY 10591 | $19K |
| MERRILL LYNCH EIN 13-5674085 INVESTMENT ADVISOR | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | 26 CENTURY HILL DRIVE LATHAM, NY 12110 | $9K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CLAIMS PROCESSING | Direct payment from the plan; Claims processing Service code 12 | 1 EXPRESS WAY ST LOUIS, MO 63121 | $9K |
| BANK OF AMERICA EIN 94-1687665 INVESTMENT CUSTODIAN | Direct payment from the plan; Custodial (securities) Service code 19 | 99 FOUNDERS PLAZA EAST HARTFORD, CT 06108 | $5K |
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 | 737 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 248 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 727 | $258K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 727 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.