No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 ADMIN SERVICES | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Named fiduciary; Participant communication; Non-monetary compensation Service code 12 | P O BOX 644546 PITTSBURGH, PA 15264 | $744K |
| BENESYS, INC EIN 38-2383171 NONE, OTHER THAN CONTRACT | Contract Administrator Service code 13 | 7180 KOLL CENTER PARKWAY SUITE 200 PLEASANTON, CA 94566 | $669K |
| THE SEGAL COMPANY EIN 13-1835864 NONE, OTHER THAN CONTRACT | Consulting (general) Service code 16 | 1230 W WASHINGTON SUITE 501 TEMPE, AZ 85281 | $129K |
| DELTA DENTAL EIN 86-0274899 NONE OTHER THAN CONTRACT | Claims processing Service code 12 | PO BOX 61595 PHOENIX, AZ 85004 | $97K |
| JENNINGS, STROUSS & SALMON EIN 86-0108229 NONE, OTHER THAN CONTRACT | Legal Service code 29 | 201 EAST WASHINGTON STREET 11TH FLOOR PHOENIX, AZ 85004 | $89K |
| BALDWIN & BALDWIN PLLC EIN 46-4370753 NONE, OTHER THAN CONTACT | Accounting (including auditing) Service code 10 | 701 NORTH 44TH STREET PHOENIX, AZ 85008 | $46K |
| WARD KEENAN AND BARRETT EIN 86-0274260 NONE, OTHER THAN CONTRACT | Legal Service code 29 | 3838 NORTH CENTRAL AVENUE SUITE 1720 PHOENIX, AZ 85012 | $44K |
| VERUS ADVISORS, INC EIN 91-1320111 NONE, OTHER THAN CONTACT | Investment management Service code 28 | 2321 ROSENCRANS SUITE 2250 EL SEGUDO, CA 94501 | $42K |
| GRANDFLOW, INC EIN 94-3211239 NONE, OTHER THAN CONTACT | Copying and duplicating Service code 36 | PO BOX 10217 PLEASANTON, CA 94588 | $39K |
| BILL STACEY CONSTRUCTION EIN 86-0709510 NONE, OTHER THAN CONTRACT | Other services Service code 49 | 3832 N 24TH ST SUITE 1 PHOENIX, AZ 85016 | $24K |
| INTERNATIONAL PRINTING COMPANY EIN 86-0528251 NONE, OTHER THAN CONTRACT | Copying and duplicating Service code 36 | 2241 S 775 ST PHOENIX, AZ 80534 | $23K |
| SEGAL SELECT INSURANCE NONE, OTHER THAN CONTRACT | Insurance services Service code 23 | 333 WEST 34TH STREET NEW YORK, NY 100012402 | $15K |
| PART D ADVISORS, INC NONE, OTHER THAN CONTRACT | Contract Administrator Service code 13 | 17199 N LAUREN PARK DRIVE SUITE 400 LIVONIA, MI 48152 | $14K |
| ROADRUNNER MAILING SERVICES NONE, OTHER THAN CONTRACT | Other services Service code 49 | 100 RYAN INDUSTRIAL CT SAN RAMON, CA 94583 | $11K |
| RISE BUSINESS SERVICES, LLC EIN 46-4907406 NONE, OTHER THAN CONTRACT | Other services Service code 49 | 750 W HAMPDEN AVE SUITE LOWER 100 ENGLENWOOD, CO 80110 | $10K |
| PITNEY BOWES EIN 84-1386389 NONE, OTHER THAN CONTRACT | Other services Service code 49 | 2225 AMERICAN DRIVE NEENAH, WI 54956 | $6K |
| HUDSON SERVICES EIN 27-2933900 NONE, OTHER THAN CONTRACT | Other services Service code 49 | PO BOX 6657 PEORIA, AZ 85385 | $6K |
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 | 1,681 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 217 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 8 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,916 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EMPLOYER DENTAL SERVICES | 200 | $18K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 2,046 | $150K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,580 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,580 | — |
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.