| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY Filed as: THE SEGAL COMPANY (EASTERN STATES) | 333 WEST 34TH STREET NEW YORK, NY 10001 | NIAGARA LIFE & HEALTH INSURANCE COMPANY | $16K | — | $16K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTH CHOICE ASSURANCE, INC EIN 23-7391136 NONE | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services Service code 12 | — | $132K |
| LOCAL 95 WELFARE FUND EIN 13-3819669 NONE | Plan Administrator Service code 14 | — | $83K |
| HO MING LAI EIN 13-2659322 NONE | Employee (plan) Service code 30 | — | $70K |
| ANNEL ORTIZ EIN 13-2659322 NONE | Employee (plan) Service code 30 | — | $58K |
| SUMMIT ACTUARIAL SERVICES LLC EIN 20-3838633 NONE | Actuarial Service code 11 | — | $46K |
| MERRILL LYNCH EIN 13-5674085 NONE | Investment management fees paid directly by plan; Direct payment from the plan; Valuation (appraisals, etc.); Investment management Service code 28 | — | $41K |
| BUCHBINDER TUNICK & CO. LLP EIN 13-1578842 NONE | Accounting (including auditing) Service code 10 | — | $39K |
| BRIDGEWAY BENEFIT (FORMERLY ISSI) EIN 23-2182079 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $39K |
| EPIPHANY RX, LLC EIN 36-4855405 NONE | Claims processing Service code 12 | — | $35K |
| ARCHER, BYINGTON, GLENNON & LEVINE EIN 26-0873462 NONE | Legal Service code 29 | — | $20K |
| LOCKTIGHT SOLUTIONS, INC. NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 11 RIDGE ROAD CRESSKILL, NJ 07626 | $9K |
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 | 486 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 500 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 428 | $76K |
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 485 | $36K |
| Stop-loss / reinsurancereinsurance | NIAGARA LIFE & HEALTH INSURANCE COMPANY | 487 | $392K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 487 | — |
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.