| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY (EASTERN STATES) INC. | 333 WEST 34TH STREET NEW YORK, NY 10001 | HCC LIFE INSURANCE COMPANY | $9K | — | $9K | 7.00% |
| WALSH JONES AGENCY INC3 Filed as: WALSH JONES AGENCY INC. | 3638 SENECA ST. WEST SENECA, NY 14224 | HARTFORD LIFE INSURANCE CO. | $3K | — | $3K | 13.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 NONE | Claims processing Service code 12 | — | $274K |
| THE SEGAL COMPANY INC EIN 13-1835864 NONE | Actuarial; Consulting (general) Service code 11 | — | $136K |
| BLITMAN AND KING, LLP EIN 16-1047304 NONE | Legal Service code 29 | — | $107K |
| LAURIE GOOD EIN 16-0776208 EMPLOYEE | Employee (plan) Service code 30 | — | $94K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 52-1796473 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 15 | — | $84K |
| MELISSA CRAWFORD EIN 16-0776208 EMPLOYEE | Employee (plan) Service code 30 | — | $62K |
| TERRI LEFLER EIN 16-0776208 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| MARIA HILBERT EIN 16-0776208 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| LIALETTE BULLOCK EIN 16-0776208 EMPLOYEE | Employee (plan) Service code 30 | — | $59K |
| ARCARA LENDA EUSANIO & STACEY CPAS EIN 47-1793720 NONE | Accounting (including auditing) Service code 10 | — | $54K |
| MANNING & NAPIER, INC. EIN 45-3328488 NONE | Investment management Service code 28 | — | $17K |
| FAIR HEALTH INC. NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 530 5TH AVENUE NEW YORK, NY 10036 | $8K |
| PC RESULTS, INC. EIN 94-3473327 NONE | Consulting (pension); Consulting (general) Service code 16 | — | $7K |
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 | 285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE INSURANCE CO. | 275 | $33K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 275 | $126K |
| Other | HARTFORD LIFE INSURANCE CO. | 213 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.