No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROKERAGE CONCEPTS INC EIN 11-3667763 THIRD PARTY ADMINISTRATO | Plan Administrator Service code 14 | — | $76K |
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 SERVICE PROVIDER | Other services Service code 49 | — | $51K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $15K |
| ACI SPECIALTY BENEFITS EIN 33-0619312 SERVICE PROVIDER | Other services Service code 49 | — | $8K |
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 | 321 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 327 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | TOTAL DENTAL ADMINISTRATORS HEALTH PLAN INC | 133 | $18K |
| Vision | CANYON INSURANCE SERVICES | 171 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 321 | $174K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 321 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 321 | $56K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INS CO | 327 | $261K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 321 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.