| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: THE SEGAL CO. EASTERN STATES, INC. | 333 W 34TH STREET NEW YORK, NY 10001 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $25K | — | $25K | 1.89% |
| DELTA DENTAL OF NEW YORK0 | 1 DELTA DRIVE MECHANICSBURG, PA 17055 | DELTA DENTAL OF NEW YORK | — | $62K | $62K | 7.02% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY-SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | — | $16K | $16K | 5.00% |
| DAVIS VISION0 | 711 TROY SCHENECTADY RD # 301 LATHAM, NY 121102424 | DAVIS VISION | — | $7K | $7K | 4.81% |
| THE SEGAL COMPANY0 Filed as: PROFESSIONAL GROUP PLANS INC SEGAL | 225 WIRELESS BLVD 2ND FLOOR HAUPPAUGE, NY 11788 | SHELTERPOINT LIFE INSURANCE COMPANY | — | $9K | $9K | 6.57% |
| NEW YORK STATE UNITED TEACHERS8 | 800 TROY SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | — | $7K | $7K | 5.00% |
| NEW YORK STATE UNITED TEACHERS4 | 800 TROY SCHENECTADY ROAD LATHAM, NY 121102424 | FIRST UNUM LIFE INSURANCE COMPANY | — | $622 | $622 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS EIN 23-7391136 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $697K |
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 | 391 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 515 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 910 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS BLUE SHIELD | 1,636 | $11.5M |
| Dental | DELTA DENTAL OF NEW YORK | 1,922 | $879K |
| Vision | DAVIS VISION | 3,759 | $148K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 392 | $342K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 392 | $131K |
| Prescription drug | CVS PHARMACY, INC | 1,712 | $9.1M |
| Stop-loss / reinsurancereinsurance | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 882 | $1.3M |
| Other(3 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 410 | $486K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,759 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.