| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BXA INSURANCE SERVICES3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 926301771 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 2.58% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP PROPERTY AND CASUALTY SERVICES | 8201 NORTH HAYDEN ROAD SCOTTSDALE, AZ 852582453 | KAISER FOUNDATION HEALTH PLAN INC. | $863 | — | $863 | 0.21% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | DELTA DENTAL OF ARIZONA | $7K | — | $7K | 9.20% |
| TERRENCE SCALI3 | NFP PROPERTY AND CASUALTY SERVICE 8201 NORTH HAYDEN ROAD SCOTTSDALE, AZ 85258 | DELTA DENTAL OF ARIZONA | $580 | — | $580 | 0.80% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.05% |
| DULEY BOLWAR & ASSOCIATES INC3 Filed as: DULEY-BOLWAR & ASSOCIATES | 14805 NORTH 73RD STREET SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $302 | — | $302 | 1.95% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $229 | — | $229 | 11.71% |
| DULEY BOLWAR & ASSOCIATES INC3 Filed as: DULEY-BOLWAR & ASSOCIATES | 14805 NORTH 73RD STREET SCOTTSDALE, AZ 85260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6 | — | $6 | 0.31% |
No Schedule C service providers reported on this filing.
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 | 162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 101 | $402K |
| Dental | DELTA DENTAL OF ARIZONA | 128 | $72K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 162 | $16K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 162 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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.