| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 | 1501 W. FOUNTAINHEAD PARKWAY SUITE 370 TEMPE, AZ 85282 | THE UNION LABOR LIFE INSURANCE COMPANY | — | $5K | $5K | 1.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO NONE OTHER THAN CONTRACT | Direct payment from the plan; Claims processing; Contract Administrator; Participant communication Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $561K |
| SOUTHWEST SERVICE ADMINISTRATORS NONE OTHER THAN CONTRACT | Plan Administrator; Contract Administrator Service code 13 | 5251 GREEN ST STE 200 MURRAY, UT 84123 | $293K |
| SPENCER FANE, LLP NONE OTHER THAN CONTRACT | Legal Service code 29 | 370 17TH STREET 4800 DENVER, CO 80202 | $71K |
| THE SEGAL COMPANY NONE OTHER THAN CONTRACT | Consulting (general) Service code 16 | 1501 W FOUNTAINHEAD PARKWAY SUITE 370 TEMPE, AZ 85282 | $59K |
| BLOMQUIST HALE CONSULTING EIN 87-0462684 NONE OTHER THAN CONTRACT | Insurance services Service code 23 | 860 E 4500 S STE 202 SALT LAKE CITY, UT 84107 | $58K |
| WSRP, LLC EIN 87-0517754 NONE OTHER THAN CONTRACT | Accounting (including auditing) Service code 10 | 155 N 400 W STE 400 SALT LAKE CITY, UT 84103 | $37K |
| US BANK EIN 93-0826646 NONE OTHER THAN CONTRACT | Trustee (bank, trust company, or similar financial institution) Service code 21 | PO BOX 287 PORTLAND, OR 97208 | $32K |
| ALTA CAPITAL MANAGEMENT EIN 77-0650218 NONE OTHER THAN CONTRACT | Soft dollars commissions; Investment management Service code 28 | 6440 S WASATCH BLVD SALT LAKE CITY, UT 84121 | $23K |
| AGINCOURT CAPITAL NONE OTHER THAN CONTRACT | Investment management Service code 28 | 200 S 10TH ST STE 800 RICHMOND, VA 23219 | $23K |
| SEGAL SELECT INSURANCE SERVICES EIN 46-0619194 NONE OTHER THAN CONTRACT | Insurance brokerage commissions and fees Service code 53 | 333 WEST 34TH STREET NEW YORK, NY 100012402 | $20K |
| WELLS FARGO ADVISORS EIN 34-1542819 NONE OTHER THAN CONTRACT | Investment management Service code 28 | 201 S MAIN ST STE 160 SALT LAKE CITY, UT 84111 | $17K |
| PRESCRIPTION CARE MANAGEMENT NONE OTHER THAN CONTRACT | Claims processing Service code 12 | PO BOX 34446 RENO, NV 895334446 | $16K |
| KENNETH B GRIMES, P.C. EIN 90-0188484 NONE OTHER THAN CONTRACT | Legal Service code 29 | 480 E 400 S, SUITE 203 SALT LAKE CITY, UT 84111 | $7K |
| SM WORKERS' NATIONAL PENSION FUND NATIONAL PENSION FUND | Other services Service code 49 | 3180 FAIRVIEW PARK DR SUITE 400 FALLS CHURCH, VA 22042 | $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 | 1,195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 50 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,240 | $378K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,240 | — |
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.