| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 333 W 34TH STREET NEW YORK, NY 100012402 | THE UNION LABOR LIFE INSURANCE COMPANY | $1K | — | $1K | 2.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE OTHER THAN CONTRACT | Contract Administrator Service code 13 | 2001 W CAMELBACK RD SUITE B350 PHOENIX, AZ 85015 | $276K |
| CIGNA HEALTHCARE EIN 06-0303370 NONE OTHER THAN CONTRACT | Claims processing; Participant communication Service code 12 | 1101 NORTH BLACK CANYON HIGHWAY PHOENIX, AZ 85029 | $234K |
| THE SEGAL COMPANY EIN 13-1835864 NONE OTHER THAN CONTRACT | Actuarial; Insurance brokerage commissions and fees Service code 11 | 1230 W WASHINGTON ST SUITE 501 TEMPE, AZ 85281 | $134K |
| BLUE CROSS BLUE SHIELD OF AZ EIN 86-0004538 NONE OTHER THAN CONTRACT | Other services Service code 49 | PO BOX 13466 PHOENIX, AZ 85002 | $81K |
| RYAN RAPP & UNDERWOOD EIN 86-0767091 NONE OTHER THAN CONTRACT | Legal Service code 29 | 3200 N CENTRAL AVE SUITE 1600 PHOENIX, AZ 85012 | $56K |
| DELTA DENTAL PLAN OF AZ EIN 86-0274899 NONE OTHER THAN CONTRACT | Claims processing Service code 12 | PO BOX 61595 PHOENIX, AZ 85082 | $39K |
| BALDWIN & BALDWIN PLLC EIN 46-4370753 NONE OTHER THAN CONTRACT | Accounting (including auditing) Service code 10 | 701 N 44TH STREET PHOENIX, AZ 85008 | $39K |
| MERRILL LYNCH EIN 13-3180817 NONE | Investment advisory (plan); Soft dollars commissions; Investment management fees paid directly by plan Service code 27 | 2555 E CAMELBACK RD #900 PHOENIX, AZ 85016 | $39K |
| NWQ INVESTMENT MANAGEMENT EIN 04-3161875 NONE OTHER THAN CONTRACT | Soft dollars commissions; Investment management fees paid directly by plan Service code 51 | 2049 CENTURY PARK EAST 18TH FLOOR LOS ANGELES, CA 90067 | $18K |
| AMERICAN HEALTH GROUP NONE OTHER THAN CONTRACT | Other services Service code 49 | 21152 S VINEYARD AVE 103 MESA, AZ 85210 | $17K |
| NECASTAR EIN 86-0140480 NONE OTHER THAN CONTRACT | Other services Service code 49 | 4315 N 12TH STREET PHOENIX, AZ 85014 | $14K |
| STRATOSE NONE OTHER THAN CONTRACT | Other services Service code 49 | TWO CONCOURSE PARKWAY SUITE 300 ATLANTA, GA 30328 | $11K |
| BMO HARRIS BANK NA EIN 36-2085229 NONE OTHER THAN CONTRACT | Custodial (securities) Service code 19 | 11270 W PARK PLACE SUITE 400 MILWAUKEE, WI 53224 | $9K |
| CHUBB EIN 13-1963496 NONE OTHER THAN CONTRACT | Insurance services Service code 23 | 2800 N CENTRAL AVENUE SUITE 1600 PHOENIX, AZ 85004 | $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 | 944 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 228 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 722 | $43K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 953 | $397K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 722 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 953 | — |
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.