| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT MALL3 | 2111 E HIGHLAND AVE PHOENIX, AZ 85016 | ULLICO | $17K | — | $17K | 3.46% |
| LABOR FIRST LLC3 Filed as: LABOR-FIRST LLC | 3000 MIDLANTIC DRIVE, SUITE 100 MOUNT LAUREL, NJ 080541513 | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC | $109K | — | $109K | 43.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 33-0441200 NONE | Direct payment from the plan; Claims processing; Float revenue; Other fees Service code 12 | — | $1.1M |
| EVERSIDE HEALTHCARE, LLC EIN 45-3449075 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $572K |
| ANTHEM INSURANCE COMPANIES, INC EIN 35-0781558 NONE | Other services; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $316K |
| TIC INTERNATIONAL EIN 13-2600875 NONE | Contract Administrator; Direct payment from the plan; Claims processing; Copying and duplicating; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 12 | — | $199K |
| TFBC LLC EIN 27-3782504 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $52K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $50K |
| JOHNSON & KROL, LLC EIN 36-4342024 NONE | Legal; Direct payment from the plan Service code 29 | — | $41K |
| DELTA DENTAL EIN 35-1545647 NONE | Contract Administrator; Direct payment from the plan; Claims processing; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 12 | — | $25K |
| STRATEGIC CAP INVEST ADVISORS, INC EIN 36-4268991 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $20K |
| HUNT INSURANCE AGENCY EIN 36-2730032 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $12K |
| EMPLOYEE RESOURCE SYSTEMS EIN 36-3867645 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $12K |
| TED WINDSOR & ASSOCIATES, LLC EIN 36-4374704 NONE | Actuarial; Consulting (general); Direct payment from the plan Service code 11 | — | $10K |
| PILLAR RX CONSULTING, LLC EIN 83-0714696 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $10K |
| INETICO, LLC (DBA VALENZ CARE) EIN 36-4869660 NONE | Other services; Direct payment from the plan Service code 49 | — | $9K |
| JP MORGAN CHASE BANK, NA EIN 13-4994650 NONE | Custodial (other than securities) Service code 18 | — | $8K |
| MED-CARE MANAGEMENT INC. EIN 88-0429522 NONE | Direct payment from the plan; Other services Service code 49 | — | $7K |
| AMALGAMATED BANK OF CHICAGO EIN 36-0721895 NONE | Custodial (securities); Investment management fees paid indirectly by plan; Direct payment from the plan; Float revenue Service code 19 | — | $2K |
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 | 515 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 216 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 731 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC | 275 | $251K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 516 | $32K |
| Stop-loss / reinsurancereinsurance | ULLICO | 553 | $478K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 553 | — |
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.