| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY | 333 WEST 34TH STREET NEW YORK, NY 10001 | THE UNION LABOR LIFE INSURANCE COMPANY | $10K | — | $10K | 0.81% |
| THE SEGAL COMPANY Filed as: SEGAL CO MIDWEST INC | 7701 FRANCE AVE S EDINA, MN 55435 | HUMANA INSURANCE COMPANY OF NEW YORK | $28K | — | $28K | 4.53% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | 111 VETERANS MEMORIAL METAIRIE, LA 70005 | HUMANA INSURANCE COMPANY OF NEW YORK | $259 | — | $259 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 CLAIMS PROCESSOR | Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $695K |
| BENESYS INC. THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 3660 STUTZ DRIVE, STE 101 CANFIELD, OH 44406 | $272K |
| DELTA DENTAL OF OHIO CLAIMS PROCESSOR | Claims processing Service code 12 | 5600 BLAZER PKWY DUBLIN, OH 43017 | $119K |
| PNC BANK BANKING SERVICES | Account maintenance fees; Trustee (bank, trust company, or similar financial institution) Service code 21 | 300 FIFTH AVE PITTSBURGH, PA 15222 | $65K |
| ALLOTTA FARLEY CO., LPA ATTORNEY | Legal Service code 29 | 3240 LEVIS COMMONS BLVD PERRYSBURG, OH 43551 | $47K |
| FIFTH THIRD BANK RETIREMENT SERVICE INVESTMENT CUSTODIAN | Investment management; Custodial (securities); Investment management fees paid directly by plan Service code 19 | 38 FOUNTAIN SQUARE PLAZA CINCINNATI, OH 45263 | $43K |
| OCPCM COMBINED FUNDS INC. EIN 20-3443534 COLLECTION AGENCY | Other fees Service code 99 | — | $22K |
| MARINER INSTITUTIONAL, LLC INVESTMENT CONSULTANT | Consulting (general) Service code 16 | 531 W. MORSE BLVD, ST 20 WINTER PARK, FL 32789 | $15K |
| YURCHYK & DAVIS CPA'S, INC. EIN 34-1638235 AUDITOR | Accounting (including auditing) Service code 10 | — | $12K |
| ACRISURE ACTUARY | Actuarial Service code 11 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | $10K |
| CITY PRINTING PRINTING SERVICES | Copying and duplicating Service code 36 | 122 OAK HILL AVE YOUNGSTOWN, OH 44502 | $10K |
| SEGAL CONSULTING BENEFIT CONSULTANT | Consulting (pension) Service code 17 | 1111 SUPERIOR AVENUE CLEVELAND, OH 44114 | $8K |
| PCORI NONE | Other fees Service code 99 | 1333 NEW HAMPSHIRE AVE NW WASHINGTON, DC 20036 | $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 | 1,199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 260 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,459 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,228 | $1.2M |
| Other | HUMANA INSURANCE COMPANY OF NEW YORK | 283 | $625K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,228 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.