| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 Filed as: NFP-NATIONAL ACCOUNT SERVICES, INC. | — | RELIASTAR | $0 | $14K | $14K | 5.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES INC - AZ | — | EYEMED | $6K | — | $6K | 8.86% |
| SCHILLER & ASSOCIATES LLC4 | — | LEGALSHIELD | $1K | — | $1K | 15.63% |
| LSG INSURANCE PARTNERS4 | — | LEGALSHIELD | $212 | — | $212 | 3.12% |
| LOCKTON COMPANIES, LLC4 Filed as: LOCKTON COMPANIES LLC | — | LEGALSHIELD | $183 | — | $183 | 2.69% |
| NFP INSURANCE SERVICES INC4 Filed as: NFP CORPORATE SERVICES NYC | — | LEGALSHIELD | $76 | — | $76 | 1.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 BENEFIT ADMIN | Claims processing; Contract Administrator Service code 12 | — | $422K |
| NFP CA INS SERVICES INC EIN 94-2741175 BROKER | Insurance agents and brokers Service code 22 | — | $193K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 BENEFIT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $23K |
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 | 1,022 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,024 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA | 174 | $543K |
| Vision | EYEMED | 1,271 | $73K |
| Life insurance | RELIASTAR | 1,252 | $284K |
| Long-term disability | RELIASTAR | 1,252 | $284K |
| Other(2 contracts, 2 carriers) | RELIASTAR | 1,252 | $291K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,271 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.