| 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 | $66K | — | $66K | 3.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 NONE | Direct payment from the plan; Contract Administrator; Participant communication; Claims processing Service code 12 | — | $877K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1579726 NONE | Contract Administrator Service code 13 | — | $742K |
| JAMES S. RAY EIN 13-4315411 NONE | Legal Service code 29 | — | $188K |
| SEGAL COMPANY EIN 13-1835864 NONE | Actuarial Service code 11 | — | $166K |
| BANK ONE INVESTMENT ADVIS EIN 31-1192865 NONE | Investment management Service code 28 | — | $77K |
| CALIBRE CPA GROUP PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $49K |
| SEGAL ROGERCASEY EIN 13-2646110 NONE | Investment advisory (plan) Service code 27 | — | $26K |
| AMALGAMATED TRUST COMPANY EIN 36-6228122 NONE | Investment advisory (plan) Service code 27 | — | $24K |
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 | 2,615 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,627 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 2,613 | $1.6M |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 2,632 | $1.9M |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 2,596 | $161K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 2,632 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,632 | — |
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.