| 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 | $8K | — | $8K | 4.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST BLUECROSS BLUESHIELD EIN 52-1385894 | Claims processing; Direct payment from the plan Service code 12 | — | $999K |
| SLEVIN & HART, P.C. EIN 52-1708613 | Direct payment from the plan; Legal Service code 29 | — | $268K |
| MORGAN LEWIS & BOCKIUS LLP EIN 23-0891050 | Legal; Direct payment from the plan Service code 29 | — | $197K |
| ANN S. GILCHRIST EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $190K |
| M&T BANK EIN 16-0538020 | Account maintenance fees; Trustee (bank, trust company, or similar financial institution); Float revenue; Custodial (securities); Direct payment from the plan Service code 19 | — | $171K |
| JULIE A. WAGNER EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $161K |
| THE SEGAL CO (EASTERN STATES), INC EIN 13-1835864 | Consulting fees; Actuarial; Direct payment from the plan; Consulting (general); Insurance brokerage commissions and fees Service code 11 | — | $158K |
| MAXIM PHYSICIAN RESOURCES | Other services; Direct payment from the plan Service code 49 | 12558 COLLECTIONS CENTRAL DRIVE CHICAGO, IL 60693 | $155K |
| AMERICAN HEALTH HOLDING INC EIN 31-1368946 | Direct payment from the plan; Other services Service code 49 | — | $144K |
| PATRICIA KELLY EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $135K |
| DOUGLAS A. CAMPBELL EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $132K |
| BASYS INC EIN 52-1796473 | Other commissions; Direct payment from the plan; Other services Service code 49 | — | $126K |
| KAREN A. FORTUNE EIN 13-5560515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $117K |
| MATTHEW STRANATHAN EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $111K |
| GRETCHEN J. FIELD EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $104K |
| JESSICA L. DEROS EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $99K |
| DAWN M. TRUMPS EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $97K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 | Claims processing; Direct payment from the plan Service code 12 | — | $88K |
| LORRAINE F. SEILER EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $86K |
| RONALD J FOURTNER EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $85K |
| HORIZON HEALTH CONSULTING GROUP EIN 52-1650540 | Consulting fees; Other services; Consulting (general); Direct payment from the plan Service code 16 | — | $85K |
| ELIZABETH R. OKUWA EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $79K |
| KARON BAIN EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| W MICHAEL MASTRICOLA EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $77K |
| NANCY J. BOPST EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $76K |
| JENNIFER L. STAMM-JONES EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $76K |
| KATHERINE B. ANDERSON EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
| CARABETH FOSTER EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $73K |
| KRISTIE L. BETHKE EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $73K |
| BUCHBINDER TUNICK & COMPANY LLP EIN 13-1578842 | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $71K |
| ANNA M. GALARZA EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $71K |
| CARLY M. MARAFIOTI EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| SUSAN A. BRUNE EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| RISK STRATEGIES COMPANY EIN 16-1689464 | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | — | $64K |
| MARY JEAN LAFINER EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $64K |
| DINA M. STOFFREGEN EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $63K |
| MELLON CAPITAL MANAGEMENT EIN 25-1442864 | Investment management; Investment management fees paid directly by plan; Direct payment from the plan Service code 28 | — | $63K |
| NATALIE SHIROBOKOV EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| ELIZABETH A. STRENNEN EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $60K |
| MARY L STARITA EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $60K |
| JUDY L. BROWN EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $59K |
| MICHELLE P. MCGLASTON EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $59K |
| KESCIA D. ALEXANDER EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| MARY K. FRAUENHOFER EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| CHERYL A. KOSTREBA EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $58K |
| PATRICIA L. HARRIS EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| VIRGINIA F. WISHON EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $57K |
| JANET E TORNABENE EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $56K |
| DEBRA L. BALDWIN EIN 13-5590515 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $56K |
| JEANNE R. BUFALINO EIN 13-5590515 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $56K |
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 | 1,628 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,600 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 16 | $168K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,714 | $189K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 88 | $23K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 2,470 | $793K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,714 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,470 | — |
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.