No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHWEST SERVICE ADMINISTRATORS EIN 86-0785790 NONE OTHER THAN CONTRACT | Contract Administrator; Claims processing; Recordkeeping fees; Copying and duplicating Service code 12 | 2550 W UNION HILLS DRIVE SUITE 290 PHOENIX, AZ 85027 | $179K |
| BLUE CROSS BLUE SHIELD EIN 86-0004538 NONE OTHER THAN CONTRACT | Other services Service code 49 | 8220 N 23RD AVE BLDG 2 PHOENIX, AZ 85021 | $125K |
| THE SEGAL COMPANY EIN 13-1835864 NONE OTHER THAN CONTRACT | Actuarial Service code 11 | 1230 W WASHINGTON SUITE 501 TEMPE, AZ 85282 | $58K |
| DELTA DENTAL PLAN EIN 86-0274899 NONE OTHER THAN CONTRACT | Other services Service code 49 | 5656 W TALAVI BLVD GLENDALE, AZ 85306 | $32K |
| ALAN BILLER & ASSOCIATES EIN 94-2854958 NONE OTHER THAN CONTRACT | Investment advisory (plan) Service code 27 | 535 MIDDLEFIELD RD #230 MENLO PARK, CA 94025 | $32K |
| BALDWIN MOFFITT LLP EIN 46-4370753 NONE OTHER THAN CONTRACT | Accounting (including auditing) Service code 10 | 8399 E INDIAN SCHOOL RD #201 SCOTTSDALE, AZ 85251 | $30K |
| ELIXIR RX SOLUTIONS NONE OTHER THAN CONTRACT | Other services Service code 49 | 2181 E AURORA RD SUITE 201 TWINSBURG, OH 44087 | $28K |
| RYAN RAPP UNDERWOOD & PACHEO EIN 86-0767091 NONE OTHER THAN CONTRACT | Legal Service code 29 | 3200 N CENTRAL AVE SUITE 2250 PHOENIX, AZ 85012 | $26K |
| GREEN LIGHT MANAGEMENT NONE OTHER THAN CONTRACT | Claims processing Service code 12 | 17015 N SCOTTSDALE RD STE 350 SCOTTSDALE, AZ 85255 | $22K |
| MD SASS EIN 13-2704843 NONE OTHER THAN CONTRACT | Investment management fees paid directly by plan Service code 51 | 1185 AVENUE OF AMERICAS 18TH FLOOR NEW YORK, NY 10036 | $15K |
| AMERICAN HEALTH GROUP INC NONE OTHER THAN CONTRACT | Other services Service code 49 | 2152 S VINEYARD SUITE 103 MESA, AZ 85210 | $14K |
| THOMPSON HINE LLP NONE OTHER THAN CONTRACT | Legal Service code 29 | 390 KEY CENTER 127 PUBLIC SQUARE CLEVELAND, OH 44114 | $14K |
| WARD, KEENAN & BARRETT NONE OTHER THAN CONTRACT | Legal Service code 29 | 2141 E CAMELBACK RD #100 PHOENIX, AZ 85016 | $8K |
| US BANK NONE OTHER THAN CONTRACT | Custodial (securities) Service code 19 | 800 NICOLLET MALL MINNEAPOLIS, MN 55402 | $8K |
| LETTERSTREAM INC NONE OTHER THAN CONTRACT | Copying and duplicating Service code 36 | 8551 E ANDERSON DR #108 SCOTTSDALE, AZ 85255 | $7K |
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 | 614 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 625 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HM LIFE INSURANCE COMPANY | 625 | $62K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 625 | $263K |
| Other(2 contracts, 2 carriers) | MINES AND ASSOCIATES, P.C. | 625 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 625 | — |
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.