| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MSM GENERAL AGENCY INC3 | PO BOX 60470 STATEN ISLAND, NY 10306 | ZURICH AMERICAN INSURANCE COMPANY | $2K | — | $2K | 10.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 SERV FOR RELATED BEN PL | Contract Administrator; Claims processing Service code 12 | — | $771K |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing; Other services Service code 12 | — | $415K |
| THE SEGAL COMPANY EIN 13-1835864 SERV FOR RELATED BEN PL | Consulting (general) Service code 16 | — | $81K |
| MED REVIEW, INC. EIN 13-3240352 NONE | Claims processing Service code 12 | — | $72K |
| TARTER KRINSKY & DROGIN LLP EIN 13-4160916 SERV FOR RELATED BEN PL | Legal Service code 29 | — | $55K |
| WEAVER AND TIDWELL, L.L.P. EIN 75-0786316 SERV FOR RELATED BENE PL | Accounting (including auditing) Service code 10 | — | $40K |
| SEGAL MARCO ADVISORS, INC. EIN 13-2646110 NONE | Investment management fees paid directly by plan Service code 51 | — | $15K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 SERV FOR RELATED BEN PL | Custodial (securities) Service code 19 | — | $11K |
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 | 1,322 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,388 | $136K |
| Short-term disability | AMALGAMATED LIFE INSURANCE COMPANY | 27 | $9K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,389 | $1.8M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,388 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,389 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.