| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: SEGAL COMPANY (WESTERN STATES), INC | 100 MONTGOMERY STREET, #500 SAN FRANCISCO, CA 94104 | WELLPOINT STOP LOSS | — | $21K | $21K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS ADMINISTRATORS EIN 38-2383171 NONE | Direct payment from the plan; Copying and duplicating; Contract Administrator Service code 13 | — | $362K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $98K |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $81K |
| DELTA DENTAL EIN 94-1461312 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $79K |
| MCMORGAN & COMPANY LLC EIN 52-2334338 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $54K |
| SALTZMAN & JOHNSON LAW CORPORATION EIN 94-2376174 NONE | Legal; Direct payment from the plan Service code 29 | — | $51K |
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Direct payment from the plan; Other services; Claims processing Service code 12 | — | $50K |
| SMARTSOURCE EIN 30-0830429 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $16K |
| ELIXIR RX SOLUTIONS, LLC EIN 91-1011712 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $9K |
| FREMONT BANK EIN 94-3170075 NONE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $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 | 589 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 176 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 765 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 58 | $8K |
| Vision | VISION SERVICE PLAN | 722 | $58K |
| Stop-loss / reinsurancereinsurance | WELLPOINT STOP LOSS | 2,550 | $417K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,550 | — |
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.