| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY4 Filed as: THE SEGAL COMPANY (EASTERN STATES) | 333 W 34TH ST, FL 2 NEW YORK, NY 10001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 4.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST BLUECROSS BLUESHIELD EIN 52-1385894 | Direct payment from the plan; Claims processing Service code 12 | — | $1.0M |
| SLEVIN & HART, P.C. EIN 52-1708613 | Direct payment from the plan; Legal Service code 29 | — | $479K |
| BASYS INC EIN 52-1796473 | Other commissions; Direct payment from the plan; Other services Service code 49 | — | $391K |
| GILCHRIST, ANN S. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $185K |
| MORGAN LEWIS & BOCKIUS LLP EIN 23-0891050 | Legal; Direct payment from the plan Service code 29 | — | $178K |
| WAGNER, JULIE A. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $157K |
| THE SEGAL CO (EASTERN STATES), INC EIN 13-1835864 | Direct payment from the plan; Actuarial; Consulting (general); Insurance brokerage commissions and fees; Consulting fees Service code 11 | — | $155K |
| KELLY, PATRICIA EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $129K |
| CAMPBELL, DOUGLAS A. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $129K |
| AMERICAN HEALTH HOLDING INC EIN 31-1368946 | Direct payment from the plan; Other services Service code 49 | — | $127K |
| M&T BANK EIN 16-0538020 | Trustee (bank, trust company, or similar financial institution); Float revenue; Custodial (securities); Account maintenance fees; Direct payment from the plan Service code 19 | — | $124K |
| FORTUNE, KAREN A. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $115K |
| GANTECH INC EIN 52-2179898 | Other services; Direct payment from the plan Service code 49 | — | $111K |
| STRANATHAN, MATTHEW EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $107K |
| FIELD, GRETCHEN J. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $105K |
| DEROS, JESSICA L. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $96K |
| TRUMPS, DAWN M. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $95K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 | Direct payment from the plan; Claims processing Service code 12 | — | $91K |
| BIRMINGHAM, MARY J. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $84K |
| SEILER, LORRAINE F. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| FOURTNER, RONALD J. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $83K |
| OPTUMRX, INC. EIN 33-0441200 | Float revenue; Other fees; Direct payment from the plan; Claims processing Service code 12 | — | $83K |
| BAIN, KARON EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $80K |
| OKUWA, ELIZABETH R. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| BOPST, NANCY J. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| MASTRICOLA, W. MICHAEL EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $76K |
| BUCHBINDER TUNICK & COMPANY LLP EIN 13-1578842 | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $75K |
| ANDERSON, KATHERINE B. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $73K |
| STAMM-JONES, JENNIFER L. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $73K |
| LESTELLE, REBECCA L. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $70K |
| MARAFIOTI, CARLY M. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| GALARZA, ANNA M. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $65K |
| HORIZON HEALTH CONSULTING GROUP EIN 52-1650540 | Consulting fees; Direct payment from the plan; Consulting (general); Other services Service code 16 | — | $65K |
| STOFFREGEN, DINA M. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| BETHKE, KRISTIE L. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| MELLON CAPITAL MANAGEMENT EIN 25-1442864 | Investment management fees paid directly by plan; Direct payment from the plan; Investment management Service code 28 | — | $62K |
| BUFALINO, JEANNE R. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| SHIROBOKOV, NATALIE EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $61K |
| LAFINER, MARY JEAN EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $61K |
| BROCKI, SUSAN A. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $60K |
| STRENNEN, ELIZABETH A. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| STARITA, MARY L. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $59K |
| HARRIS, PATRICIA L. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $59K |
| BROWN, JUDY L. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| ALEXANDER, KESCIA D. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $57K |
| KOSTREBA, CHERYL A. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| TORNABENE, JANET E. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| FRAUENHOFER, MARY K. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $55K |
| BELLAMY, TRACEY D. EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $55K |
| WISHON, VIRGINIA F. EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $54K |
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 | 1,670 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,566 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,236 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 18 | $201K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,702 | $221K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 94 | $33K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 2,589 | $742K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,702 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,589 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.