| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: SEGAL CO. MIDWEST INC THE | 7701 FRANCE AVE. S STE. 225 EDINA, MN 554355288 | HUMANA INSURANCE COMPANY | $160K | — | $160K | 4.63% |
| THE SEGAL COMPANY3 Filed as: SEGAL CO. MIDWEST INC THE | 7701 FRANCE AVE. S STE. 225 EDINA, MN 554355288 | HUMANA INSURANCE COMPANY | $300 | — | $300 | 7.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $1.3M |
| PRUDENT RX NONE | Insurance services; Direct payment from the plan Service code 23 | 3820 NORTHDALE BLVD., STE 311-A TAMPA, FL 33624 | $198K |
| PENNY BROWN EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $170K |
| FAULKNER, HOFFMAN & PHILLIPS, LLP EIN 34-1909706 NONE | Shareholder servicing fees; Direct payment from the plan Service code 50 | — | $147K |
| AETNA NONE | Insurance services; Direct payment from the plan Service code 23 | 151 FARMINGTON AVE. HARTFORD, CT 06156 | $132K |
| PEGGY GOTTHARDT EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $107K |
| DELTA DENTAL NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | P.O. BOX 9085 FARMINGTON HILLS, MI 483339085 | $96K |
| NATHAN DANIELS EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $88K |
| IDWC OF SO PENSION TRUST EIN 31-6038516 NONE | Plan Administrator; Direct payment from the plan Service code 14 | — | $79K |
| TAYLOR COMMUNICATIONS, INC. EIN 41-0852411 NONE | Direct payment from the plan; Other services Service code 49 | — | $74K |
| PROSTAFF GRAPHICS NONE | Other services; Direct payment from the plan Service code 49 | 65 TAHLEQUAH TRAIL SPRINGBORO, OH 45066 | $73K |
| TIM SEDLACK EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $72K |
| CLARK, SCHAEFER, HACKETT & CO. EIN 31-0800053 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $67K |
| CINDY MILLHOUSE EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $61K |
| CVS/CAREMARK NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | ONE CVS DRIVE WOONSOCKET, RI 02895 | $60K |
| PAMELA CALVERT EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $59K |
| MEGAN WOODS EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $57K |
| BRIDGEWAY BENEFIT TECHNOLOGIES, LLC EIN 52-1796473 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $55K |
| BRIGID DUNCAN EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $50K |
| MIDWEST PAINTING NONE | Other services; Direct payment from the plan Service code 49 | 855 CONGRESS PARK SUITE 101 DAYTON, OH 45459 | $40K |
| BROWSE MCDOWELL, LPA EIN 34-1108723 NONE | Legal; Direct payment from the plan Service code 29 | — | $35K |
| RUTHAN BLACKMORE EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $30K |
| PITNEY BOWES GLOBAL FINANCIAL NONE | Direct payment from the plan; Other services Service code 49 | 3001 SUMMER ST. STAMFORD, CT 06905 | $28K |
| WASTE MANAGEMENT OF OHIO, INC. NONE | Other services; Direct payment from the plan Service code 49 | P.O. BOX 3020 MONROE, WI 53566 | $24K |
| OLIVIA OVERMEYER EIN 31-0557391 EMPLOYEE | Employee (plan) Service code 30 | — | $13K |
| AES OHIO/DP&L INC. EIN 31-0258470 NONE | Other services; Direct payment from the plan Service code 49 | — | $13K |
| DATAMATION IMAGING SERVICES NONE | Other services; Direct payment from the plan Service code 49 | 7700 GRIFFIN WAY B WILLOWBROOK, IL 60527 | $13K |
| OVERMYER HALL ASSOCIATES EIN 27-2481536 NONE | Direct payment from the plan; Insurance services; Insurance agents and brokers Service code 22 | — | $12K |
| CARRIER CORPORATION EIN 06-0991716 NONE | Other services; Direct payment from the plan Service code 49 | — | $10K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $10K |
| VERIZON WIRELESS NONE | Direct payment from the plan; Other services Service code 49 | P.O. BOX 16801 NEWARK, NJ 071016801 | $8K |
| JOHNSON CONTROLS SECURITY SOLUTIONS NONE | Direct payment from the plan; Other services Service code 49 | 6600 CONGRESS AVE. BOCA RATON, FL 33487 | $7K |
| FRIENDS OFFICE EIN 34-1690683 NONE | Other services; Direct payment from the plan Service code 49 | — | $7K |
| ADP NONE | Direct payment from the plan; Other services Service code 49 | 1 ADP BLVD ROSELAND, NJ 07068 | $7K |
| DOCUSIGN INC. EIN 91-2183967 NONE | Direct payment from the plan; Other services Service code 49 | — | $6K |
| NEXTIVIA NONE | Other services; Direct payment from the plan Service code 49 | 9451 EAST VIA DE VENTURA SCOTTSDALE, AZ 85256 | $6K |
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 | 3,321 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,779 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HUMANA INSURANCE COMPANY | 1,499 | $3.5M |
| Vision | VISION SERVICE PLAN | 3,264 | $371K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 5,306 | $726K |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 1,478 | $2.0M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 3,014 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,306 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.