| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY | 101 WACKER DRIVE, SUITE 500 CHICAGO, IL 60606 | THE UNION LABOR LIFE INSURANCE COMPANY | — | $6K | $6K | 1.55% |
| THE SEGAL COMPANY Filed as: SEGAL CO MIDWEST INC | 7701 FRANCE AVE S STE 225 EDINA, MN 55435 | HUMANA INSURANCE COMPANY | $22K | — | $22K | 11.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION LABOR LIFE INSURANCE CO. CLAIMS PROCESSOR | Claims processing Service code 12 | 1625 EYE STREET, NW WASHINGTON, DC 20006 | $429K |
| MEDICAL MUTUAL OF OHIO EIN 34-1922587 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $193K |
| HUMANA INSURANCE COMPANY EIN 39-1263473 CLAIMS PROCESSOR | Actuarial Service code 11 | — | $182K |
| BENESYS, INC. EIN 38-2383171 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Copying and duplicating; Contract Administrator; Participant communication Service code 10 | — | $125K |
| PNC BANK, NATIONAL ASSOCIATION EIN 22-1146430 INVESTMENT CUSTODIAN | Custodial (other than securities); Consulting (general); Custodial (securities) Service code 16 | — | $47K |
| THE SEGAL COMPANY EIN 13-1975125 BENEFIT CONSULTANT | Consulting (general) Service code 16 | — | $44K |
| PLUMBERS LOCAL 396 COMBINED FUNDS COLLECTION FUND | Other fees Service code 99 | 3660 STUTZ DRIVE, STE 101 CANFIELD, OH 44406 | $15K |
| FAULKNER, HOFFMAN & PHILLIPS ATTORNEY | Legal Service code 29 | 20445 EMERALD PKWY 210 CLEVELAND, OH 44101 | $13K |
| YURCHYK & DAVIS CPA'S, INC EIN 34-1638235 AUDITOR | Accounting (including auditing) Service code 10 | — | $8K |
| PARSONS RISK STRATEGIES, LLC ACTUARY | Actuarial Service code 11 | 347 TIMBERLANE DRIVE AVON LAKE, OH 44012 | $5K |
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 | 394 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 157 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 551 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL OF OHIO | 551 | $193K |
| Prescription drug | MEDICAL MUTUAL OF OHIO | 551 | $193K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 551 | $392K |
| Other | HUMANA INSURANCE COMPANY | 200 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 551 | — |
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.