| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | — | BERKLEY LIFE AND HEALTH INSURANCE CO. | — | $13K | $13K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $2K | $6K | 7.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $1K | $4K | 7.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASHTON TIFFANY EIN 86-0804559 INSURANCE ADMINISTRATOR | Contract Administrator Service code 13 | — | $300K |
| AMERIBEN IEC GROUP EIN 82-0497661 CLAIMS PROCESSING | Claims processing Service code 12 | — | $126K |
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 INSURANCE ADMINISTRATION | Insurance services Service code 23 | — | $83K |
| WILLIS OF ARIZONA EIN 86-0223854 CONSULTING | Consulting (general) Service code 16 | — | $35K |
| WILLIS TOWERS WATSON EIN 53-0181291 CONSULTING | Consulting (general) Service code 16 | — | $30K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 INSURANCE ADMINISTRATOR | Insurance services Service code 23 | — | $20K |
| ALLIANT INSURANCE SERVICES EIN 33-0785439 INSURANCE SERVICES | Insurance services Service code 23 | — | $16K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 AUDITOR | Accounting (including auditing) Service code 10 | — | $13K |
| HEALTH EQUITY EIN 52-2383166 HEALTH SAVINGS ACCOUNT A | Other fees Service code 99 | — | $13K |
| HEALTHWAVES CORPORATION EIN 86-0554636 CONSULTING | Consulting (general) Service code 16 | — | $9K |
| ZELIS NETWORK SOLUTIONS EIN 58-2167964 INSURANCE SERVICES | Insurance services Service code 23 | — | $9K |
| CERIDIAN HCM, INC. EIN 59-3228107 EMPLOYEE ASSISTANCE PROG | Other fees Service code 99 | — | $7K |
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 | 384 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 389 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 557 | $91K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 202 | $31K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 418 | $80K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 418 | $80K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE CO. | 557 | $269K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 418 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 557 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.