| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | — | HCC LIFE INSURANCE COMPANY | $14K | — | $14K | 5.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSOCIATED ADMINISTRATORS, LLC EIN 65-1205077 NONE | Direct payment from the plan; Plan Administrator; Contract Administrator Service code 13 | — | $88K |
| EMPIRE HEALTHCARE ASSURANCE, INC EIN 23-7391136 NONE | Direct payment from the plan; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $76K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $63K |
| EXPRESS SCRIPTS INC EIN 43-1420563 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $43K |
| THE SEGAL CO (EASTERN STATES), INC EIN 13-1835864 NONE | Consulting (general); Insurance brokerage commissions and fees; Insurance agents and brokers Service code 16 | — | $25K |
| SEI INVESTMENT MANAGEMENT CORP EIN 23-1707341 NONE | Investment advisory (plan); Investment management; Investment management fees paid directly by plan; Custodial (securities); Investment management fees paid indirectly by plan Service code 19 | — | $17K |
| KAUFF MCGUIRE & MARGOLIS, LLP EIN 13-3573855 NONE | Legal; Direct payment from the plan Service code 29 | — | $15K |
| CHEIRON, INC NONE | Consulting (general); Insurance agents and brokers; Insurance brokerage commissions and fees Service code 16 | 8300 GREENSBORO DR SUITE 800 MCLEAN, VA 22102 | $14K |
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 | 117 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 129 | $6K |
| Short-term disability | AMALGAMATED LIFE INSURANCE COMPANY | 129 | $57K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 129 | $274K |
| Other | AMALGAMATED LIFE INSURANCE COMPANY | 129 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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.