| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY Filed as: THE SEGAL CO MIDWEST INC | 3800 AMERICAN BLVD W BLOOMINGTON, MN 554314420 | HUMANA INSURANCE | $36K | — | $36K | 2.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUMANA MEDICAL EIN 36-1263473 NONE | Claims processing Service code 12 | N19W24133 RIVERWOOD DR, STE 300 WAUKESHA, WI 531881174 | $1.9M |
| TEAMSTERS LOCAL 344 EIN 39-0146203 LABOR UNION | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 10020 W GREENFIELD AVE MILWAUKEE, WI 53214 | $265K |
| SAV-RX EIN 47-0527013 NONE | Plan Administrator; Claims processing Service code 12 | 224 NORTH PARK AVE FREMONT, NE 68025 | $146K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Other commissions; Actuarial; Consulting (general) Service code 11 | 333 W 34TH ST NEW YORK, NY 10001 | $78K |
| BMO HARRIS BANK EIN 36-2085229 NONE | Custodial (securities) Service code 19 | 111 E KILBOURN AVE, STE 200 MILWAUKEE, WI 53202 | $71K |
| SOLDON LAW FIRM, LLC EIN 27-4757308 NONE | Legal Service code 29 | 3541 N SUMMIT AVE SHOREWOOD, IL 53211 | $63K |
| EMPLOYER HEALTHCARE COOPERATIVE INC EIN 39-1675538 NONE | Claims processing Service code 12 | 5510 NOBEL DR, STE 200 FITCHBURG, WI 53711 | $60K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | 7501 WISCONSIN AVE, STE 1200 WEST BETHESDA, MD 20814 | $25K |
| EYE MED NONE | Claims processing Service code 12 | 4000 LUXOTTICA PLACE I MASON, OH 45040 | $14K |
| COMPUTER MANAGEMENT ASSISTANCE CO NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 104 N 9TH ST MT VERNON, IL 62864 | $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 | 1,809 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,198 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,007 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA DENTAL INSURANCE COMPANY | 2,963 | $149K |
| Life insurance | UNION LABOR LIFE INSURANCE COMPANY | 1,832 | $225K |
| Stop-loss / reinsurancereinsurance | UNION LABOR LIFE INSURANCE COMPANY | 2,278 | $277K |
| Other | UNION LABOR LIFE INSURANCE COMPANY | 1,832 | $225K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,027 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.