No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHWEST SERVICE ADMINISTRATORS EIN 86-0785790 NONE | Recordkeeping fees; Contract Administrator; Copying and duplicating; Claims processing Service code 12 | 2250 W UNION HILLS DRIVE, SUITE 290 PHOENIX, AZ 85027 | $176K |
| BLUE CROSS BLUE SHIELD EIN 86-0004538 NONE | Other services Service code 49 | 8220 N 23RD AVE BLDG 2 PHOENIX, AZ 85021 | $117K |
| GREEN LIGHT MANAGEMENT NONE | Claims processing Service code 12 | 17015 N SCOTTSDALE RD STE 350 SCOTTSDALE, AZ 85255 | $74K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial Service code 11 | 1230 W WASHINGTON SUITE 501 TEMPE, AZ 85282 | $58K |
| RYAN RAPP & UNDERWOOD EIN 86-0767091 NONE | Legal Service code 29 | 3200 N CENTRAL AVE SUITE 2250 PHOENIX, AZ 85012 | $44K |
| DELTA DENTAL PLAN EIN 86-0274899 NONE | Other services Service code 49 | 5656 W TALAVI BLVD GLENDALE, AZ 85306 | $32K |
| BALDWIN MOFFITT PLLC EIN 46-4370753 NONE | Accounting (including auditing) Service code 10 | 8399 E INDIAN SCHOOL RD #201 SCOTTSDALE, AZ 85251 | $29K |
| ALAN BILLER & ASSOCIATES EIN 94-2854958 NONE | Investment advisory (plan) Service code 27 | 535 MIDDLEFIELD RD #230 MENLO PARK, CA 94025 | $27K |
| ENVISION PHARMACEUTICAL SERVICES EIN 05-0570786 NONE | Other services Service code 49 | 2181 E AURORA RD SUITE 201 TWINSBURG, OH 44087 | $26K |
| MOSAIC EIN 52-0821478 NONE | Copying and duplicating Service code 36 | — | $14K |
| WARD, KEENAN & BARRETT NONE | Legal Service code 29 | 2141 E CAMELBACK RD #100 PHOENIX, AZ 85016 | $13K |
| MD SASS EIN 13-2704843 NONE | Investment management fees paid directly by plan Service code 51 | 1185 AVENUE OF AMERICAS 18TH FLOOR NEW YORK, NY 10036 | $13K |
| WELLS FARGO BANK EIN 41-1492157 NONE | Custodial (securities) Service code 19 | 100 W WASHINGTON ST 22ND FLOOR PHOENIX, AZ 85003 | $10K |
| THOMPSON HINE LLP NONE | Legal Service code 29 | 390 KEY CENTER 127 PUBLIC SQUARE CLEVELAND, OH 44114 | $8K |
| LETTERSTREAM INC NONE | Copying and duplicating Service code 36 | 8551 E ANDERSON DR #108 SCOTTSDALE, AZ 85255 | $5K |
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 | 586 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 606 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HM LIFE INSURANCE COMPANY | 586 | $60K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 586 | $274K |
| Other | MINES AND ASSOCIATES, P.C. | 586 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 586 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.