| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 333 WEST 34TH STREET NEW YORK, NY 10001 | THE UNION LABOR LIFE INSURANCE COMPANY | $2K | — | $2K | 1.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS EIN 48-0952857 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $525K |
| THE SEGAL COMPANY EIN 13-1975125 ACTUARY | Actuarial Service code 11 | — | $73K |
| SPENCER FANE BRITT AND BROWNE EIN 44-0561981 ATTORNEY | Legal Service code 29 | — | $72K |
| NOVAK BIRKS, P.C. EIN 43-1122456 ACCOUNTANT | Accounting (including auditing) Service code 10 | — | $65K |
| MELANIE CLARK EIN 44-0582944 EMPLOYEE | Employee (plan) Service code 30 | — | $60K |
| ISSI IT CONSULTANT | Consulting fees Service code 70 | 3000 SOUTH LENOLA ROAD MAPLE SHADE, NJ 08052 | $54K |
| STACY KUHL EIN 44-0582944 EMPLOYEE | Employee (plan) Service code 30 | — | $52K |
| DANIELLE WILEY EIN 44-0582944 PLAN ADMINISTRATOR | Employee (plan); Plan Administrator Service code 14 | — | $42K |
| STRATEGIC CAPITAL INVESTMENT ADV INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | 700 E. BUTTERFIELD ROAD LOMBARD, IL 60148 | $42K |
| NATIONAL INVESTMENT SERVICES INVESTMENT MANAGER | Investment management Service code 28 | 777 E. WISCONSIN AVENUE MILWAUKEE, WI 53202 | $35K |
| STROKE DETECTION PLUS CONSULTING | Consulting (general) Service code 16 | 2407 SW 9TH STREET DES MOINES, IA 50315 | $30K |
| KMR IT CONSULTANT | Consulting fees Service code 70 | 6800 JERICHO TPKE, ST 120 STOSSET, NY 11791 | $12K |
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 | 696 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 256 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 952 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 752 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 752 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.