| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMPANY, INC | 333 WEST 34TH STREET NEW YORK, NY 10001 | EVEREST REINSURANCE COMPANY | $7K | — | $7K | 3.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTH CHOICE ASSURANCE, INC EIN 23-7391136 CLAIMS PROCESSOR | Direct payment from the plan; Claims processing Service code 12 | 165 BROADWAY NEW YORK, NY 10006 | $411K |
| TRIVELLA & FORTE LLP EIN 13-4070172 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 1311 MAMARONECK AVENUE WHITE PLAINS, NY 10605 | $225K |
| CLARITY TESTING SERVICES EIN 13-3869722 CLAIMS PROCESSOR | Claims processing; Direct payment from the plan Service code 12 | 150 WHITE PLAINS ROAD SUITE 204 TARRYTOWN, NY 10591 | $150K |
| WAGNER & ZWERMAN LLP EIN 11-2836481 ACCOUNTANT | Direct payment from the plan; Accounting (including auditing) Service code 10 | 201 OLD COUNTRY ROAD SUITE 202 MELVILLE, NY 11747 | $125K |
| THE SEGAL COMPANY, INC. EIN 13-1835864 ACTUARY | Direct payment from the plan; Actuarial; Consulting fees Service code 11 | 333 WEST 34TH STREET NEW YORK, NY 10001 | $73K |
| ANDREW MACKLE EIN 13-6123972 PLAN ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | 160 SOUTH CENTRAL AVENUE ELMSFORD, NY 10523 | $70K |
| JEFFREY ALTHOLZ, MD EIN 13-3624710 MEDICAL CONSULTANT | Direct payment from the plan; Consulting fees; Consulting (general) Service code 16 | 150 WHITE PLAINS ROAD SUITE 204 TARRYTOWN, NY 10591 | $48K |
| TPA CORPORATION EIN 13-3329882 COMPUTER CONSULTANT | Consulting (general); Consulting fees; Direct payment from the plan Service code 16 | 531 ROUTE 52 SUITE 4 CARMEL, NY 10512 | $45K |
| BOLTON PARTNERS NORTHEAST, INC. EIN 27-3666661 ATTORNEY | Direct payment from the plan Service code 50 | 9000 MIDLANTIC DRIVE SUITE 100 MOUNT LAUREL, NJ 08054 | $41K |
| ARMANDO HERRERA EIN 13-6123972 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 160 SOUTH CENTRAL AVENUE ELMSFORD, NY 10523 | $35K |
| WESTCHESTER MEDICAL CARE PLLC EIN 20-0106098 MEDICAL CONSULTANT | Direct payment from the plan; Consulting fees; Consulting (general) Service code 16 | 150 WHITE PLAINS ROAD SUITE 201 TARRYTOWN, NY 10591 | $35K |
| JANINE FEOLA EIN 13-6123972 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 160 SOUTH CENTRAL AVENUE ELMSFORD, NY 10523 | $35K |
| JAMES SEDA EIN 13-6123972 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 160 SOUTH CENTRAL AVENUE ELMSFORD, NY 10523 | $26K |
| ADRIENNE JORGE EIN 13-6123972 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 160 SOUTH CENTRAL AVENUE ELMSFORD, NY 10523 | $25K |
| THEODOR H. BROWN DDS EIN 13-3043628 DENTAL CONSULTANT | Direct payment from the plan; Consulting fees; Consulting (general) Service code 16 | 358 NORTH BROADWAY SLEEPY HOLLOW, NY 10591 | $25K |
| MAGNACARE ADMINISTRATIVE SVCS, LLC. EIN 12-3410766 CLAIMS PROCESSOR | Direct payment from the plan; Claims processing Service code 12 | 1600 STEWART AVENUE 7TH FLOOR WESTBURY, NY 11590 | $22K |
| BARNES, IACCARINO & SHEPHERD LLP EIN 26-3858697 ATTORNEY | Legal; Direct payment from the plan Service code 29 | 3 SURREY LANE HEMPSTEAD, NY 11550 | $12K |
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 | 923 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 188 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 825 | $226K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 825 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.