| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 1501 W FOUNTAINHEAD PARKWAY #370 TEMPE, AZ 85282 | THE UNION LABOR LIFE INSURANCE COMPANY | $7K | — | $7K | 1.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE EIN 59-1031071 NONE | Direct payment from the plan; Contract Administrator; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $284K |
| SOUTHWEST SERVICE ADMIN EIN 86-0576428 NONE | Contract Administrator Service code 13 | — | $164K |
| THE SEGAL COMPANY EIN 94-1503999 NONE | Consulting (general) Service code 16 | — | $100K |
| WEINBERG ROGER & ROSENFELD EIN 94-2458080 NONE | Legal Service code 29 | — | $18K |
| SEGAL SELECT INSURANCE BROKERAGE EIN 44-0619194 NONE | Insurance services Service code 23 | — | $18K |
| BANK OF OKLAHOMA EIN 73-0780382 NONE | Custodial (securities) Service code 19 | — | $9K |
| BALDWIN MOFFITT BEHM LLP EIN 46-4370753 NONE | Accounting (including auditing) Service code 10 | — | $9K |
| LETTERSTREAM NONE | Copying and duplicating Service code 36 | 8551 E ANDERSON DR #108 SCOTTSDALE, AZ 85255 | $8K |
| VISION SERVICE PLAN EIN 91-6056925 NONE | Insurance services Service code 23 | — | $8K |
| J & R GRAPHICS NONE | Copying and duplicating Service code 36 | 638 W INDIAN SCHOOL RD PHOENIX, AZ 85013 | $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 | 911 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 911 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA DENTAL | 911 | $33K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 911 | $18K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 911 | $464K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 911 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 911 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.