| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: SEGAL GROUP | 333 WEST 34TH STREET NEW YORK, NY 10012 | TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY | $23K | — | $23K | 4.00% |
| THE SAVITZ ORGANIZATION INC4 Filed as: THE SAVITZ ORGANIZATION | 1845 WALNUT ST, 14TH FLOOR PHILADELPHIA, PA 19103 | USABLE LIFE | $560 | — | $560 | 3.62% |
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | $0 | $309 | $309 | 2.00% |
| CBIZ BENEFITS & INSURANCE SERVICES4 Filed as: CBIZ BENEFITS & INSURANCE | SERVICES, INC 700 W. 47TH ST. SUITE 1100 KANSAS CITY, MO 64112 | USABLE LIFE | $213 | — | $213 | 1.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 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 | — | $576K |
| JEAN FAIRCHILD EIN 13-5605495 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $185K |
| MILDRED DIAZ EIN 13-5605495 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| COHEN, WEISS & SIMON LLP EIN 13-1592323 NONE | Legal; Direct payment from the plan Service code 29 | — | $59K |
| JOSE RIVERA EIN 13-5605495 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| D. D. SERVICES INC. EIN 11-2705347 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $57K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $55K |
| XAVIER MORENO EIN 13-5605495 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $51K |
| CRISTINA JIMENEZ EIN 13-5605495 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| THE SEGAL CO. (EASTERN STATES), INC EIN 13-1835864 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $49K |
| NELLY DAGER EIN 13-5605495 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $38K |
| TPA COMPUTER CORPORATION EIN 13-3329882 COMPUTER CONSULTANT | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $30K |
| DTM CONSULTING EIN 04-3607413 COMPUTER CONSULTANT | Recordkeeping and information management (computing, tabulating, data processing, etc.); Employee (plan) Service code 15 | — | $5K |
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 | 1,135 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC | 62 | $1.2M |
| Life insurance(2 contracts, 2 carriers) | AMALGAMATED LIFE INSURANCE COMPANY | 1,076 | $68K |
| Stop-loss / reinsurancereinsurance | TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY | 958 | $576K |
| Other | AMALGAMATED LIFE INSURANCE COMPANY | 1,076 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,076 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.