| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MW BAGNALL COMPANY3 Filed as: M W BAGNALL COMPANY | 1345 E CHANDLER BLVD BLDG 103 PHOENIX, AZ 85048 | HEALTHNET OF AZ | $26K | — | $26K | 5.20% |
| MW BAGNALL COMPANY5 Filed as: BAGNALL COMPANY | 1345 EAST CHANDLER BLVD BLDG 1, SUITE 103 PHOENIX, AZ 85048 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $562 | — | $562 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COVENTRY HEALTH CARE OF MISSOURI EIN 43-1372307 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 750 PRIDES CROSSING SUITE 200 NEWARK, DE 19713 | $484K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Claims processing; Contract Administrator Service code 12 | 12399 GRAVOIS ROAD ST. LOUIS, MO 63127 | $67K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 21653 NETWORK PLACE CHICAGO, IL 60673 | $20K |
| CONNECT YOUR CARE EIN 26-1274092 NONE | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 307 INTERNATIONAL CIRCLE SUITE 200 HUNT VALLEY, MD 21030 | $16K |
| ST. LOUIS BUSINESS HEALTH COALITION EIN 43-1694859 NONE | Insurance agents and brokers Service code 22 | 8888 LADUE ROAD SUITE 250 ST. LOUIS, MO 63124 | $10K |
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 | 1,180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HEALTHNET OF AZ | 1,179 | $521K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 70 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,179 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.