| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CSA GENERAL INS AGENCY INC | PO BOX 81019 PHOENIX, AZ 85069 | SYMETRA LIFE INSURANCE COMPANY | — | $6K | $6K | 1.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE OTHER THAN CONTRACT | Contract Administrator Service code 13 | 2001 W CAMELBACK RD STE B350 PHOENIX, AZ 850157404 | $632K |
| BLUE CROSS BLUE SHIELD EIN 86-0004538 NONE OTHER THAN CONTRACT | Insurance services Service code 23 | 8220 N 23RD AVE PHOENIX, AZ 85021 | $160K |
| THE SEGAL COMPANY EIN 94-1503999 NONE OTHER THAN CONTRACT | Consulting (general) Service code 16 | PO BOX 63610 PHOENIX, AZ 25082 | $101K |
| VERUS EIN 91-1320111 NONE OTHER THAN CONTRACT | Investment advisory (plan) Service code 27 | 999 THIRD AVENUE, SUITE 4200 SEATTLE, WA 98104 | $20K |
| THE UNION LABOR LIFE INSURANCE COMP EIN 13-1423090 NONE OTHER THAN CONTRACT | Insurance services Service code 23 | 1624 EYE STREET, NW WASHINGTON, DC 20006 | $19K |
| WARD KEENAN AND BARRETT, PC EIN 86-0274260 NONE OTHER THAN CONTRACT | Legal Service code 29 | 3838 NORTH CENTRAL 1720 PHOENIX, AZ 85012 | $17K |
| WELLS FARGO BANK EIN 86-0002768 NONE OTHER THAN CONTRACT | Custodial (securities) Service code 19 | 100 WEST WASHINGTON 22ND FLOOR MACS4101-28 PHOENIX, AZ 85003 | $17K |
| JENNINGS, STROUSS & SALMON EIN 86-0108229 NONE OTHER THAN CONTRACT | Legal Service code 29 | ONE EAST WASHINGTON STREET SUITE 1900 PHOENIX, AZ 85004 | $16K |
| BALDWIN & BALDWIN PLLC EIN 46-4370753 NONE OTHER THAN CONTRACT | Accounting (including auditing) Service code 10 | 701 NORTH 44TH STREET PHOENIX, AZ 85008 | $16K |
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 | 976 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 70 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,046 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,031 | $10K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 989 | $49K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 890 | $310K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 989 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,031 | — |
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."
No prospect flags tripped on this filing.