| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMPANY (EASTERN STATES) | 333 WEST 34TH ST NEW YORK, NY 100012402 | SIRIUS AMERICA INSURANCE CO. | $28K | — | $28K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Other services; Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $310K |
| FAIRCHILD, JEAN R EIN 13-5605495 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $191K |
| THE SEGAL CO (EASTERN STATES), INC. EIN 13-1835864 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Actuarial Service code 11 | — | $109K |
| SCHULTHEIS & PANETTIERI, LLP EIN 13-1577780 AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $91K |
| RIVERA, JOSE D EIN 13-5605495 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $60K |
| JIMENEZ, CRISTINA EIN 13-5605495 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $59K |
| COHEN, WEISS AND SIMON LLP EIN 13-1592323 NONE | Legal; Direct payment from the plan Service code 29 | — | $57K |
| D.D. SERVICES INC. EIN 11-2705347 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $37K |
| DIAZ, MILDRED EIN 13-5605495 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $33K |
| TPA COMPUTER CORPORATION EIN 13-3329882 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $31K |
| DTM CONSULTING LLC EIN 04-3607413 COMPUTER CONSULTANT | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $11K |
| EXPRESS SCRIPTS INC. EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $9K |
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 | 972 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 972 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC | 0 | $73K |
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 992 | $46K |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA INSURANCE CO. | 972 | $696K |
| Other | AMALGAMATED LIFE INSURANCE COMPANY | 992 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 992 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.