| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY (WESTERN STATES) INC | 100 MONTEGOMERY ST., STE 500 SAN FRANCISCO, CA 94104 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH PA | $87K | $13K | $100K | 23.00% |
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY (WESTERN STATES) INC | 100 MONTEGOMERY ST., STE 500 SAN FRANCISCO, CA 94104 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH,PA | — | $3K | $3K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REHN & ASSOCIATES EIN 91-1008626 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $189K |
| AETNA NONE | Claims processing; Direct payment from the plan Service code 12 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $178K |
| LINDQUIST LLP EIN 52-2385296 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $71K |
| THE SEGAL COMPANY, INC. EIN 94-1503999 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $68K |
| TURNER, STOEVE & GAGLIARDI, P.S. EIN 91-1282506 NONE | Legal; Direct payment from the plan Service code 29 | — | $64K |
| WASHINGTON TRUST BANK EIN 91-0462347 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $15K |
| FIRST CHOICE HEALTH NETWORK INC. EIN 91-1272768 NONE | Direct payment from the plan; Other services Service code 49 | — | $12K |
| THE PACIFIC HEALTH COALITION EIN 92-0116216 NONE | Other services; Direct payment from the plan Service code 49 | — | $12K |
| AMERICAN HEALTH HOLDING INC. EIN 31-1368946 NONE | Other services; Direct payment from the plan Service code 49 | — | $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 | 680 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 59 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 739 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH,PA | 724 | $102K |
| Dental | DELTA DENTAL OF WASHINGTON | 1,763 | $676K |
| Vision | VISION SERVICE PLAN | 729 | $83K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 724 | $36K |
| Other(3 contracts, 2 carriers) | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH PA | 724 | $571K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,763 | — |
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.