| 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 | $17K | — | $17K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 CLAIMS PROCESSING | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | 3075 VANDEREAR WAY CINCINNATI, OH 45209 | $239K |
| MARSHALL & MOSS ADMIN SERVICES EIN 81-2845805 ACCOUNTING | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 1400 OLD COUNTRY ROAD, STE 406 WESTBURY, NY 11590 | $47K |
| THE SEGAL COMPANY, INC. EIN 13-1835864 ACTUARY | Direct payment from the plan; Consulting fees; Actuarial Service code 11 | 333 WEST 34TH STREET NEW YORK, NY 10001 | $43K |
| MICHAEL SCHWADRON EIN 13-1777458 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 41 KNOLLWOOD ROAD ELMSFORD, NY 10523 | $41K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 LEGAL | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $38K |
| IRINA HONCZARENKO EIN 13-1777458 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 41 KNOLLWOOD ROAD ELMSFORD, NY 10523 | $29K |
| MARSHALL & MOSS PAYROLL COMPLIANCE EIN 04-3652965 PAYROLL AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | 1400 OLD COUNTRY ROAD, STE 406 WESTBURY, NY 11590 | $19K |
| WAGNER & ZWERMAN LLP EIN 11-2836481 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 201 OLD COUNTRY ROAD, SUITE 202 MELVILLE, NY 11747 | $19K |
| STACEY BRAUN ASSOCIATES, INC. EIN 13-2889432 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management Service code 28 | 377 BROADWAY NEW YORK, NY 10013 | $7K |
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 | 321 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 321 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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.