| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: THE SEGAL CO MIDWEST INC | 7701 FRANCE AVE S SUITE 225 EDINA, MN 55435 | HUMANA INSURANCE COMPANY | $124K | — | $124K | 5.48% |
| THE SEGAL COMPANY3 Filed as: THE SEGAL CO MIDWEST INC | 7701 FRANCE AVE S SUITE 225 EDINA, MN 55435 | HUMANA INSURANCE COMPANY | $13K | — | $13K | 5.88% |
| THE SEGAL COMPANY3 Filed as: THE SEGAL CO MIDWEST INC | 7701 FRANCE AVE S SUITE 225 EDINA, MN 55435 | HUMANA INSURANCE COMPANY OF NEW YORK | $100 | — | $100 | 5.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE SEGAL COMPANY, INC. EIN 13-1975125 NONE | Insurance brokerage commissions and fees; Actuarial; Consulting (general) Service code 11 | — | $182K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Plan Administrator; Copying and duplicating; Claims processing Service code 12 | — | $122K |
| UMR, INC. EIN 39-1995276 NONE | Claims processing; Other insurance fees and expenses Service code 12 | — | $71K |
| REINHART BOERNER VAN DEUREN S.C. EIN 39-1126909 NONE | Legal Service code 29 | — | $37K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $26K |
| SPENCER FANE LLP EIN 44-0561981 NONE | Legal Service code 29 | — | $8K |
| BMO HARRIS BANK NA EIN 36-2085229 NONE | Custodial (securities); Soft dollars commissions; Float revenue; Trustee (bank, trust company, or similar financial institution); Securities brokerage commissions and fees; Distribution (12b-1) fees; Finders' fees / placement fees Service code 19 | — | $7K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Contract Administrator; Claims processing Service code 12 | — | $7K |
| MINES & ASSOCIATES, INC. EIN 84-1028610 NONE | Claims processing; Contract Administrator Service code 12 | — | $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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 905 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 905 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | HUMANA INSURANCE COMPANY | 1,132 | $2.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,132 | — |
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."
No prospect flags tripped on this filing.