| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UMR, INC.3 | 115 W. WAUSAU AVENUE WAUSAU, WI 54401 | HCC LIFE INSURANCE COMPANY | $2K | — | $2K | 0.99% |
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMPANY MIDWEST, INC. | 101 NORTH WACKER DRIVE, SUITE 500 CHICAGO, IL 60606 | HCC LIFE INSURANCE COMPANY | $25 | — | $25 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Plan Administrator; Claims processing; Copying and duplicating Service code 12 | — | $2.3M |
| UMR, INC. EIN 39-1995276 NONE | Other insurance fees and expenses; Claims processing Service code 12 | — | $2.0M |
| DELTA DENTAL OF COLORADO EIN 84-0568337 NONE | Contract Administrator; Claims processing Service code 12 | — | $307K |
| REINHART BOERNER VAN DEUREN S.C. EIN 39-1126909 NONE | Legal Service code 29 | — | $255K |
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 NONE | Other services; Participant communication; Direct payment from the plan; Claims processing; Named fiduciary; Contract Administrator Service code 12 | — | $219K |
| SPENCER FANE LLP EIN 44-0561981 NONE | Legal Service code 29 | — | $213K |
| MINES AND ASSOCIATES, P.C. EIN 84-1028610 NONE | Claims processing Service code 12 | — | $185K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Claims processing; Contract Administrator Service code 12 | — | $173K |
| THE SEGAL COMPANY, INC. EIN 13-1975125 NONE | Actuarial; Consulting (general) Service code 11 | — | $171K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $103K |
| HORIZON ACTUARIAL SERVICES, LLC EIN 26-1370698 NONE | Consulting (general); Actuarial Service code 11 | — | $80K |
| LAZARD ASSET MANAGEMENT NONE | Securities brokerage commissions and fees; Investment management fees paid directly by plan; Soft dollars commissions; Investment management Service code 28 | 30 ROCKEFELLER PLAZA NEW YORK, NY 10112 | $16K |
| BMO HARRIS BANK NA EIN 36-2085229 NONE | Trustee (bank, trust company, or similar financial institution); Securities brokerage commissions and fees; Soft dollars commissions; Finders' fees / placement fees; Custodial (securities); Distribution (12b-1) fees; Float revenue Service code 19 | — | $10K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $5K |
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 | 9,976 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 9,976 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF COLORADO | 4,519 | $23.9M |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 9,657 | $208K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 7,741 | $176K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 9,657 | $208K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,657 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.