| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: THE SEGAL CO EASTERN STATES IN | 333 W 34TH ST. NEW YORK, NY 10001 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.02% |
| CSA GENERAL INS AGENCY INC3 Filed as: CSA GENERAL INS AGENCY INC. | 2480 W LAS PALMARITAS DR PHOENIX, AZ 85021 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.66% |
| THE SEGAL COMPANY3 Filed as: THE SEGAL CO INC OF AZ | 1230 W WASHINGTON ST STE 501 TEMPE, AZ 85281 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.23% |
| THE SEGAL COMPANY3 Filed as: THE SEGAL CO INC OF AZ | 1230 W WASHINGTON ST STE 501 TEMPE, AZ 85281 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $673 | — | $673 | 3.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FRINGE BENEFIT SERVICES INC EIN 84-0620086 NONE | Contract Administrator Service code 13 | 7010 N BROADWAY SUITE 106 DENVER, CO 80221 | $742K |
| BLUE CROSS BLUE SHIELD OF AZ EIN 86-0004538 NONE | Other insurance fees and expenses Service code 73 | PO BOX 13466 PHOENIX, AZ 85002 | $272K |
| UNITED CLAIMS SOLUTIONS EIN 20-0908354 NONE | Claims processing Service code 12 | 10835 N 25TH AVE SUITE 105 PHOENIX, AZ 85029 | $216K |
| MERRILL LYNCH EIN 13-3180817 NONE | Investment advisory (plan) Service code 27 | 2555 E CAMELBACK ROAD SUITE 900 PHOENIX, AZ 85016 | $176K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Consulting (general) Service code 16 | 1230 W WASHINGTON SUITE 501 TEMPE, AZ 85281 | $141K |
| EMPLOYERS RISK SERVICES NONE | Claims processing Service code 12 | 1240 FAIRWAY ST BOWLING GREEN, KY 42103 | $104K |
| WARD KEENAN AND BARRETT, PC EIN 86-0274260 NONE | Legal Service code 29 | 3838 N CENTRAL AVE SUITE 1720 PHOENIX, AZ 85012 | $67K |
| DELTA DENTAL EIN 86-0274899 NONE | Claims processing Service code 12 | PO BOX 61595 PHOENIX, AZ 85004 | $66K |
| JENNINGS, STROUSS & SALMON EIN 86-0108229 NONE | Legal Service code 29 | 201 E WASHINGTON ST 11TH FLOOR PHOENIX, AZ 85004 | $50K |
| BALDWIN & BALDWIN PLLC EIN 46-4370753 NONE | Accounting (including auditing) Service code 10 | 701 NORTH 44TH STREET PHOENIX, AZ 85008 | $48K |
| MCMORGAN & CO EIN 94-1650768 NONE | Investment management Service code 28 | ONE FRONT STREET SUITE 500 SAN FRANCISCO, CA 94111 | $34K |
| EAP PREFERRED EIN 86-0438189 NONE | Other services Service code 49 | 99 EAST VIRGINA AVE SUITE 275 PHOENIX, AZ 85004 | $32K |
| HEALTHWAVES EIN 86-0554636 NONE | Other services Service code 49 | 1615 W UNIVERSITY DR SUITE 137 TEMPE, AZ 85281 | $31K |
| WELLS FARGO BANK EIN 41-1592157 NONE | Custodial (securities) Service code 19 | 100 W WASHINGTON 22ND FLOOR PHOENIX, AZ 85003 | $28K |
| PITNEY BOWES NONE | Copying and duplicating Service code 36 | 3001 SUMMER STREET STAMFORD, CT 06926 | $19K |
| DPN USA, LLC DBA HEALTHFAIR PLUS NONE | Other services Service code 49 | 1030 SPRING VILLAS POINT SUITE 3000 WINTER SPRINGS, FL 32708 | $17K |
| MATRIX GROUP INTERNATIONAL INC EIN 54-2023680 NONE | Other services Service code 49 | 2711 JEFFERSON DAVISHWY SUITE 120 ARLINGTON, VA 22202 | $13K |
| CHUBB EIN 13-1963496 NONE | Insurance services Service code 23 | 2800 N CENTRAL AVENUE SUITE 1600 PHOENIX, AZ 85004 | $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 | 1,240 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EMPLOYERS DENTAL SERVICES | 188 | $74K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,891 | $76K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,445 | $105K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,981 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,981 | — |
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.