| 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 | $74K | $0 | $74K | 1.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DEREK DAVIS EIN 13-2643045 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $173K |
| KISHOR MANCHIKALAPATI EIN 13-2643045 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $82K |
| DAWN NEDD EIN 13-2643045 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| ALEJANDRA VEGA-ROJAS EIN 13-2643045 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $58K |
| SPIVAK LIPTON LLP EIN 13-3494495 NONE | Legal; Direct payment from the plan Service code 29 | — | $49K |
| SCHULTHEIS & PANETTIERI LLP EIN 13-1577780 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $49K |
| PATRICE SACKS EIN 13-2643045 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $48K |
| WILMINGTON TRUST EIN 51-0055023 NONE | Investment management; Custodial (securities); Investment management fees paid directly by plan Service code 19 | — | $45K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $40K |
| SHAKUWRA CHERYL DABRE EIN 13-2643045 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $35K |
| ADMINISTRATIVE SERVICES ONLY, INC. EIN 11-2995970 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $33K |
| GALLAGHER FIDUCIARY ADVISORS, LLC EIN 36-4291971 NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $17K |
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 | 1,828 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,828 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 583 | $6.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 583 | $6.0M |
| Vision | AETNA LIFE INSURANCE COMPANY | 583 | $6.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 583 | — |
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.