| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 333 W 34TH STREET NEW YORK, NY 100012417 | RELIASTAR LIFE INSURANCE COMPANY | $70K | — | $70K | 3.50% |
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY EASTERN STATES, INC. | 333 W 34TH STREET NEW YORK, NY 10001 | HCC LIFE INSURANCE COMPANY | $44K | — | $44K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 06-0303370 NONE | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $1.4M |
| IOMM&P EIN 13-6020335 SPONSORING UNION | Direct payment from the plan; Plan Administrator Service code 14 | — | $312K |
| DELTA DENTAL EIN 23-1667011 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $236K |
| PATRICK MCCULLOUGH EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $204K |
| SLEVIN & HART EIN 52-1708613 NONE | Non-monetary compensation; Legal; Direct payment from the plan Service code 29 | — | $203K |
| MULTIPLAN EIN 13-3068979 NONE | Other services; Claims processing; Direct payment from the plan Service code 12 | — | $197K |
| KENNETH RYAN EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $151K |
| ANN MARIE MCCULLOUGH EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $144K |
| PAULA PHILLIPS EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $129K |
| DALE CLARK EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $102K |
| STACEY SULLIVAN EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $100K |
| JOSEPH GIUSTO EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $100K |
| DAVID ROMANO EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $97K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial; Direct payment from the plan; Insurance brokerage commissions and fees; Consulting (general) Service code 11 | — | $95K |
| MADELINE PETRELLI EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $90K |
| MICHAEL MCCULLOUGH EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $84K |
| ALFRED MANZO EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $74K |
| MARY RIDGELY EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $72K |
| MARCIA FAWTHROP EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $66K |
| AMERICAN HEALTH HOLDINGS LLC EIN 31-1368946 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $64K |
| DEBRA CAVEY EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $64K |
| ALICE ANDRZEJEWSKI EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $57K |
| RUSS BALZARINI EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $52K |
| MARY JURNEY EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $50K |
| JESSICA WINDSOR EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $49K |
| GORFINE SCHILLER & GARDYN PA EIN 52-1231901 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $49K |
| ELIZABETH HOLLYWOOD EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $48K |
| DIANE FITZBERGER EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $48K |
| DENISE BRINKMAN EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $48K |
| VERA BRENNAN EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $46K |
| AMY FOSSETT EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $45K |
| CATHY WRIGHT EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $45K |
| HOWARD ROBERTS EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $43K |
| JENNIFER KELLNER EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $43K |
| SEAN MEAD EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $43K |
| LISA LINDAUER EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $42K |
| KATHRYNE MCGEE EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $42K |
| ERIC MCCOLLUM EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $42K |
| MAYRA ROBLES EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $42K |
| CHARLENE ROGERS EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $40K |
| CATHERINE GEOGHEGAN EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $40K |
| SYDNIE BOSSOM EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $36K |
| CYNTHIA LAMARTINA EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $36K |
| MASHA JURNEY EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $35K |
| ELIZABETH GARY EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $31K |
| JOHN OLIVER EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $31K |
| ROFFE ENTERPRISES EIN 52-1650540 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $25K |
| DORIS MILLER EIN 13-6696938 EMPLOYEE | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $23K |
| JEAN ADAMS-MENCIK EIN 13-6696938 EMPLOYEE | Direct payment from the plan; Employee (plan sponsor) Service code 35 | — | $22K |
| STEPTOE & JOHNSON EIN 52-1349790 NONE | Non-monetary compensation; Legal; Direct payment from the plan Service code 29 | — | $21K |
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 | 3,477 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,721 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE INSURANCE COMPANY | 2,661 | $105K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 982 | $3.1M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL | 89 | $202K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,661 | — |
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."
No prospect flags tripped on this filing.