| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY EASTERN STATES | 333 WEST 34TH ST NEW YORK, NY 100012402 | HARTFORD LIFE INSURANCE COMPANY | $10K | $421 | $10K | 9.08% |
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY EASTERN STATES INC | 1920 N STREET NW WASHINGTON, DC 20036 | HARTFORD LIFE INSURANCE COMPANY | $0 | $343 | $343 | 0.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAGNACARE EIN 11-3410766 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $308K |
| EMPIRE BCBS EIN 23-7391136 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $260K |
| FERNANDEZ, ALFRED EIN 13-5548780 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $201K |
| MUNICH RE STOP LOSS, INC. EIN 65-0644164 NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | — | $148K |
| THE SEGAL CO (EASTERN STATES), INC. EIN 13-1835864 NONE | Actuarial; Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 11 | — | $127K |
| CASANOVA, TERESA EIN 13-5548780 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $100K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $95K |
| TURKOVIC, BRANCA EIN 13-5548780 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $85K |
| DELMAR, MICHELLE EIN 13-5548780 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $73K |
| TINEO, MIGUELINA EIN 13-5548780 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $72K |
| ORTIZ, NANCY EIN 13-5548780 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $56K |
| LORE, LINDA EIN 13-5548780 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $49K |
| AWAN, AKRAM EIN 13-5548780 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $48K |
| BATISTA, JULISSA EIN 13-5548780 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $45K |
| GUARASCIO, MARGARET EIN 13-5548780 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $44K |
| NEW & KARFUNKEL, P.C. EIN 22-2553368 NONE | Legal; Direct payment from the plan Service code 29 | — | $42K |
| WEAVER BARKSDALE EIN 61-1217255 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $41K |
| MEDREVIEW INC. EIN 13-3240352 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $34K |
| MOLINA, JOCELINA EIN 13-5548780 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $31K |
| E.G. ACCOUNTING EIN 11-3756843 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $30K |
| MARVIN BELSKY, MD EIN 11-2224384 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $30K |
| SCHAFER CULLEN CAPITAL MANAGEMENT I EIN 13-3089070 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $28K |
| CARY KANE, LLP EIN 20-1942442 NONE | Legal; Direct payment from the plan Service code 29 | — | $24K |
| MR. MICROCHIP EIN 59-3084068 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $21K |
| SIDS DENTAL EIN 11-2995970 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $19K |
| MATKOWSKA, BEATA EIN 13-5548780 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $18K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Direct payment from the plan; Claims processing; Other fees; Contract Administrator Service code 12 | — | $18K |
| TEAMSTER CENTER SERVICE FUND EIN 13-1964856 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $16K |
| MORGAN STANLEY SMITH BARNEY EIN 26-4310632 NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $16K |
| DAVIS VISION EIN 11-3051991 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $7K |
| SEGAL SELECT INSURANCE SERVICES INC | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $3K |
| SEGAL SELECT INS SERVICES, INC. EIN 46-0619194 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $0 |
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 | 708 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 736 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability(2 contracts) | HARTFORD LIFE INSURANCE COMPANY | 515 | $196K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 515 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.