| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 333 W 34TH STREET, FLOOR 2 NEW YORK, NY 10001 | AETNA LIFE INSURANCE COMPANY | $62K | $0 | $62K | 1.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DEREK DAVIS EIN 13-2643045 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $159K |
| ADMINISTRATIVE SERVICES ONLY, INC. EIN 11-2995970 NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $87K |
| KISHOR MANCHIKALAPATI EIN 13-2643045 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| DAWN NEDD EIN 13-2643045 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| SPIVAK LIPTON, LLP EIN 13-3494495 NONE | Legal; Direct payment from the plan Service code 29 | — | $55K |
| ALEJANDRA VEGA-ROJAS EIN 13-2643045 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| MAYRA COLON EIN 13-2643045 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $40K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $38K |
| SHAKUWRA CHERYL DABRE EIN 13-2643045 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $35K |
| JP MORGAN CHASE BANK N.A. EIN 13-4994650 NONE | Investment management; Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $17K |
| GALLAGHER FIDUCIARY ADVISORS, LLC EIN 36-4291971 NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $17K |
| WILMINGTON TRUST EIN 16-1486454 NONE | Investment management; Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $15K |
| PRITCHARD INDUSTRIES, INC. NONE | Other services; Direct payment from the plan Service code 49 | 1120 AVENUE OF THE AMERICAS NEW YORK, NY 10036 | $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 | 3,646 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,646 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 585 | $5.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 585 | $5.1M |
| Vision | AETNA LIFE INSURANCE COMPANY | 585 | $5.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 585 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.