| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY Filed as: THE SEGAL COMPANY EASTERN STAT | 333 WEST 34TH STREET NEW YORK, NY 10001 | GUARDIAN | $39K | — | $39K | 3.20% |
| INSMED INS AGENCY INC3 | 500 MAMARONECK AVE SUITE 408 HARRISON, NY 10528 | GUARDIAN | $20K | — | $20K | 3.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Direct payment from the plan; Float revenue; Other services Service code 12 | — | $2.0M |
| HOUSE STAFF BENEFIT PLAN EIN 13-6203291 AFFILIATED BENEFIT PLAN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $234K |
| CIR, SEIU EIN 13-2771401 AFFILIATED UNION | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $230K |
| STACEY BRAUN ASSOCIATES, INC EIN 13-2884932 NONE | Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 51 | — | $153K |
| THE SEGAL COMPANY EIN 13-1835864 | Direct payment from the plan; Actuarial Service code 11 | — | $75K |
| STEPHEN M PERLITSH EIN 13-3805593 | Legal; Direct payment from the plan Service code 29 | — | $63K |
| KEENAN AND ASSOCIATES EIN 95-2798626 | Insurance brokerage commissions and fees; Direct payment from the plan Service code 50 | — | $56K |
| ROGOFF & COMPANY PC EIN 13-2688836 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $32K |
| HEALTH PLAN SYSTEMS, INC. EIN 01-0589640 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $28K |
| COHEN, WEISS AND SIMON, LLP. EIN 25-1919594 NONE | Legal; Direct payment from the plan Service code 29 | — | $17K |
| SEGAL SELECT INSURANCE SERVICES, IN EIN 46-0619194 | Direct payment from the plan; Insurance brokerage commissions and fees Service code 50 | — | $17K |
| EMPIRE HEALTHCHOICE HMO, INC. EIN 13-3874803 NONE | Float revenue; Other services; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $16K |
| SEGAL MARCO ADVISORS EIN 13-2466110 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $16K |
| KMR SYSTEMS CORPORATION EIN 13-3192128 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $15K |
| BOHUNKA GOLDSTEIN EIN 20-0782535 | Legal; Direct payment from the plan Service code 29 | — | $13K |
| POINT POLISH EIN 51-8550918 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $7K |
| WEISS ZARETT BROFMAN SONNENKLAR PC EIN 04-3655487 | Legal; Direct payment from the plan Service code 29 | — | $7K |
| HOLTZMAN HELFMAN LLP EIN 20-2560017 | Legal; Direct payment from the plan Service code 29 | — | $7K |
| BING & EINWOHNER, LLP EIN 82-0911457 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $6K |
| LOCKTIGHT SOLUTIONS EIN 22-3825157 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $6K |
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 | 4,447 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 81 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,528 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 3,235 | $0 |
| Dental | GUARDIAN | 2,859 | $1.2M |
| Life insurance | GUARDIAN | 4,474 | $625K |
| Long-term disability | GUARDIAN | 4,474 | $625K |
| Stop-loss / reinsurancereinsurance | AMERICAN ALTERNATIVE INSURANCE CORPORATION | 3,216 | $896K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,474 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.