| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INCOR SERVICES INC3 | 1500 E BETHANY HOME ROAD, STE 200 PHOENIX, AZ 85014 | AETNA LIFE INSURANCE CO. | $87K | — | $87K | 1.64% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | AETNA LIFE INSURANCE CO. | $17K | — | $17K | 0.32% |
| INCOR SERVICES INC3 | 1500 E. BETHANY HOME RD #200 PHOENIX, AZ 85014 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $11K | — | $11K | 11.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INCOR SERVICES INC N/A | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 1500 E BETHANY HOME ROAD SUITE 200 PHOENIX, AZ 85014 | $263K |
| ROGERS BENEFIT GROUP INC N/A | Insurance services Service code 23 | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | $105K |
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 | 1,994 | 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) | 1,994 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 1,994 | $5.3M |
| Dental | AETNA LIFE INSURANCE CO. | 1,994 | $5.3M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,459 | $94K |
| Life insurance | AETNA LIFE INSURANCE CO. | 1,994 | $5.3M |
| Short-term disability | AETNA LIFE INSURANCE CO. | 1,994 | $5.3M |
| Long-term disability | AETNA LIFE INSURANCE CO. | 1,994 | $5.3M |
| Other | AETNA LIFE INSURANCE CO. | 1,994 | $5.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,994 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.