| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 1501 W. FOUNTAINHEAD PKWY STE 370 TEMPE, AZ 85282 | HUMANA INSURANCE COMPANY | $30K | — | $30K | 2.77% |
| THE SEGAL COMPANY3 | 333 W 34TH STREET NEW YORK, NY 10001 | SYMETRA LIFE INSURANCE COMPANY | $10K | — | $10K | 1.07% |
| THE SEGAL COMPANY3 | 333 W 34TH STREET NEW YORK, NY 10001 | THE UNION LABOR LIFE INSURANCE COMPANY | $1K | — | $1K | 1.79% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTHCARE EIN 59-1031071 NONE | Other services; Float revenue; Direct payment from the plan; Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation Service code 12 | 1101 NORTH BLACK CANYON HIGHWAY PHOENIX, AZ 85029 | $744K |
| BLUE CROSS BLUE SHIELD NONE | Claims processing Service code 12 | 2444 W LAS PALMARITAS DR PHOENIX, AZ 85021 | $498K |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Contract Administrator Service code 13 | 2001 W CAMELBACK RD STE B350 PHOENIX, AZ 85015 | $365K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial Service code 11 | 1230 W WASHINGTON STREET SUITE 501 TEMPE, AZ 85281 | $133K |
| RYAN RAPP UNDERWOOD & PACHECO PLC EIN 86-0767091 NONE | Legal Service code 29 | 3200 N CENTRAL AVE STE 2250 PHOENIX, AZ 85012 | $58K |
| NECASTAR EIN 86-0140480 NONE | Other services Service code 49 | 4315 N 12TH STREET PHOENIX, AZ 85014 | $42K |
| BALDWIN MOFFITT PLLC EIN 46-4370753 NONE | Accounting (including auditing) Service code 10 | 8399 E INDIAN SCHOOL RD #201 SCOTTSDALE, AZ 85251 | $32K |
| ALAN D BILLER ASSOCIATES NONE | Investment advisory (plan) Service code 27 | 535 MIDDLEFIELD RD #230 MENLO PARK, CA 94025 | $20K |
| INTERNATIONAL PRINTING COMPANY NONE | Copying and duplicating Service code 36 | 2241 S 7TH STREET PHOENIX, AZ 85034 | $12K |
| BMO HARRIS BANK NONE | Other fees; Custodial (securities) Service code 19 | PO BOX 97558 LAS VEGAS, NV 89196 | $8K |
| SEGAL SELECT INSURANCE EIN 46-0619194 NONE | Insurance brokerage commissions and fees Service code 53 | — | $7K |
| WARD, KEENAN & BARRETT PC NONE | Legal Service code 29 | 3838 N CENTRAL AVE. #1720 PHOENIX, AZ 85016 | $6K |
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 | 1,346 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 161 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,507 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE COMPANY | 282 | $1.1M |
| Dental | DELTA DENTAL INSURANCE COMPANY | 1,664 | $938K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,300 | $62K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,679 | $922K |
| Other(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE COMPANY | 1,871 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,871 | — |
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.