| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS3 | P.O. BOX 5817 WALLINGFORD, CT 06492 | THE UNION LABOR LIFE INSURANCE COMPANY | $11K | — | $11K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $141K |
| ANTHEM HEALTH PLANS, INC. EIN 06-1475928 NONE | Direct payment from the plan; Claims processing; Contract Administrator; Other services; Float revenue Service code 12 | — | $70K |
| SEGAL COMPANY EIN 13-1928058 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $58K |
| SHUMAKER, LOOP & KENDRICK EIN 34-4439491 NONE | Legal; Direct payment from the plan Service code 29 | — | $17K |
| SAV-RX EIN 47-0527013 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $17K |
| LABOR FIRST, LLC EIN 06-1750191 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $17K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $15K |
| HINES AND ASSOCIATES EIN 36-3545085 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $14K |
| LOWER HUDSON VALLEY EIN 13-3240307 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $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 | 216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 217 | $11K |
| Prescription drug | EXPRESS SCRIPTS MEDICARE (MEDCO CONTAINMENT LIFE INS. CO.) | 39 | $105K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 226 | $227K |
| Other(2 contracts, 2 carriers) | UNITED AMERICAN INSURANCE COMPANY | 217 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.