No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 NONE | Claims processing; Contract Administrator Service code 12 | — | $261K |
| DELTA DENTAL OF ARIZON EIN 86-0274899 NONE | Claims processing; Contract Administrator Service code 12 | — | $25K |
| AMERICAN SPECIALTY HEALTH SYSTEMS EIN 33-0938349 NONE | Insurance agents and brokers Service code 22 | — | $0 |
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 | 598 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 600 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 429 | $387K |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 429 | $387K |
| Vision | BLUE CROSS BLUE SHIELD OF ARIZONA | 429 | $387K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,161 | $316K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,161 | $316K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,161 | $316K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 429 | $387K |
| Other | HARTFORD LIFE AND ACCIDENT | 1,161 | $316K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,161 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.