| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY4 Filed as: THE SEGAL CO. (EASTERN STATES), INC | 333 WEST 34TH STREET NEW YORK, NY 100012402 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $26K | $19K | $45K | 6.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Claims processing Service code 12 | — | $521K |
| FAIRCHILD, JEAN R EIN 13-5605495 NONE | Employee (plan) Service code 30 | — | $176K |
| COHEN, WEISS & SIMON LLP EIN 13-1592323 NONE | Legal Service code 29 | — | $79K |
| DIAZ, MILDRED EIN 13-5605495 NONE | Employee (plan) Service code 30 | — | $59K |
| THE SEGAL CO. (EASTERN STATES), INC EIN 13-1835864 NONE | Insurance brokerage commissions and fees; Actuarial Service code 11 | — | $57K |
| MORENO, XAVIER EIN 13-5605495 NONE | Employee (plan) Service code 30 | — | $55K |
| RIVERA, JOSE D. EIN 13-5605495 NONE | Employee (plan) Service code 30 | — | $55K |
| D.D. SERVICES INC. EIN 11-2705347 NONE | Claims processing Service code 12 | — | $52K |
| JIMENEZ, CRISTINA EIN 13-5605495 NONE | Employee (plan) Service code 30 | — | $47K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing) Service code 10 | — | $46K |
| TPA COMPUTER CORPORATION EIN 13-3329882 COMPUTER CONSULTANT | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $29K |
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 | 1,025 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,025 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 1,058 | $55K |
| Stop-loss / reinsurancereinsurance | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | 929 | $658K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,058 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.