| 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 | $2K | — | $2K | 2.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 86-0004538 NONE | Claims processing Service code 12 | 2444 W LAS PALMARITAS DR PHOENIX, AZ 85021 | $1.6M |
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Contract Administrator Service code 13 | — | $630K |
| INTERNATIONAL PRINTING NONE | Copying and duplicating Service code 36 | 2241 S 7TH STREET PHOENIX, AZ 85034 | $361K |
| AMERICAN HEALHT LAW ASSOC NONE | Legal Service code 29 | PO BOX 79340 BALTIMORE, MD 21279 | $222K |
| VARNUM LLP NONE | Legal Service code 29 | 333 BRIDGE ST NW #170 GRAND RAPIDS, MI 49504 | $222K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial Service code 11 | — | $110K |
| NECASTAR EIN 86-0140480 NONE | Other services Service code 49 | — | $75K |
| ALAN D BILLER ASSOCIATES EIN 94-2854958 NONE | Investment advisory (plan) Service code 27 | — | $50K |
| RYAN RAPP PACHECO & KELLY PLC EIN 86-0767091 NONE | Legal Service code 29 | — | $37K |
| BALDWIN MOFFITT BEHM LLP EIN 46-4370753 NONE | Accounting (including auditing) Service code 10 | — | $30K |
| STOUT RISIUS ROSS LLC EIN 87-3592543 NONE | Legal Service code 29 | — | $28K |
| KELLY LAW GROUP NONE | Legal Service code 29 | 3800 N CENTRAL AVE #350 PHOENIX, AZ 85012 | $20K |
| SEGAL SELECT INSURANCE EIN 46-0619194 NONE | Insurance brokerage commissions and fees Service code 53 | — | $9K |
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 | 1,963 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 182 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 6,393 | $1.5M |
| Dental | DELTA DENTAL INSURANCE COMPANY | 3,365 | $1.4M |
| Vision | VISION SERVICE PLAN | 3,140 | $49K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,997 | $86K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 6,393 | $442K |
| Other(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE COMPANY | 2,180 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,393 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.