| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DULEY BOLWAR & ASSOCIATES INC3 Filed as: DULEY BOLWARD & ASSOCIATES | 14805 N 73RD STREET PHOENIX, AZ 85260 | RELIASTAR INSUR COMP | $57K | — | $57K | 8.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WISCONSIN EIN 39-0138065 CLAIMS PROCESSOR | Contract Administrator; Claims processing; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 1351 WM HOWARD TAFT ROAD CINCINNATI, OH 45206 | $1.1M |
| DELTA DENTAL EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | 2801 HOOVER ROAD STEVENS POINT, WI 54481 | $59K |
| RELIASTAR LIFE INSUR CO EIN 41-0451140 CLAIMS PROCESSOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | 20 WASHINGTON AVE S MINNEAPOLIS, MN 55401 | $31K |
| DULEY BOLWAR & ASSOCIATES EIN 01-0586968 | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 14805 N 73RD ST PHOENIX, AZ 85260 | $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 | 2,157 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | RELIASTAR INSUR COMP | 2,668 | $837K |
| Short-term disability | RELIASTAR INSUR COMP | 2,668 | $692K |
| Long-term disability | RELIASTAR INSUR COMP | 2,668 | $692K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,668 | — |
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.