| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY Filed as: SEGAL CO MIDWEST INC | 7701 FRANCE AVE S STE 225 EDINA, MN 55435 | HUMANA INSURANCE COMPANY | $26K | — | $26K | 9.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BERKSHIRE HATHAWAY SPEC. INSURANCE CLAIMS PROCESSOR | Claims processing Service code 12 | 3555 FARNAM ST OMAHA, NE 68131 | $428K |
| HUMANA INSURANCE COMPANY CLAIMS PROCESSOR | Claims processing Service code 12 | 101 E. MAIN ST. LOUISVILLE, KY 40202 | $277K |
| MEDICAL MUTUAL OF OHIO CLAIMS PROCESSOR | Claims processing Service code 12 | 100 AMERICAN RD BROOKLYN, OH 44144 | $217K |
| BENESYS, INC. THIRD PARTY ADMINISTRATOR | Contract Administrator; Copying and duplicating; Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Participant communication Service code 10 | 3660 STUTZ DRIVE, STE 101 CANFIELD, OH 44406 | $134K |
| PNC BANK, NATIONAL ASSOCIATION EIN 22-1146430 INVESTMENT CUSTODIAN | Custodial (other than securities); Consulting (general); Custodial (securities) Service code 16 | — | $74K |
| THE SEGAL COMPANY BENEFIT CONSULTANT | Consulting (general) Service code 16 | 1111 SUPERIOR AVENUE CLEVELAND, OH 44114 | $54K |
| PLUMBERS LOCAL 396 COMBINED FUNDS COLLECTION FUND | Other fees Service code 99 | 3660 STUTZ DRIVE, STE 101 CANFIELD, OH 44406 | $25K |
| FAULKNER, HOFFMAN & PHILLIPS ATTORNEY | Legal Service code 29 | 20445 EMERALD PKWY 210 CLEVELAND, OH 44101 | $19K |
| YURCHYK & DAVIS CPA'S, INC EIN 34-1638235 AUDITOR | Accounting (including auditing) Service code 10 | — | $9K |
| PARSONS RISK STRATEGIES, LLC ACTUARY | Actuarial Service code 11 | 347 TIMBERLANE DRIVE AVON LAKE, OH 44012 | $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 | 419 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 172 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 591 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL OF OHIO | 461 | $217K |
| Prescription drug | MEDICAL MUTUAL OF OHIO | 461 | $217K |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE | 591 | $392K |
| Other | HUMANA INSURANCE COMPANY | 199 | $277K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 591 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.