| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POMEROY & POMEROY | 3134 N 7TH STREET, SUITE 1 PHOENIX, AZ 85014 | NATIONWIDE LIFE INSURANCE COMPANY | $30K | — | $30K | 4.06% |
| POMEROY & ASSOCIATES LLC Filed as: POMEROY & ASSOCIATES | 3134 N 7TH STREET, SUITE 1 PHOENIX, AZ 85014 | METROPOLITAN LIFE INSURANCE CO | $9K | $858 | $10K | 9.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAXOR ADMINISTRATIVE SERVICES EIN 37-1692805 NONE | Plan Administrator; Claims processing Service code 12 | 5045 NORTH 12TH STREET, SUITE A PHOENIX, AZ 85014 | $222K |
| BEECH STREET CORP EIN 95-3778850 NONE | Other fees Service code 99 | 25500 COMMERCENTRE DRIVE LAKE FOREST, CA 926308835 | $77K |
| POMEROY & POMEROY EIN 86-0651460 NONE | Consulting fees Service code 70 | 3134 N. 7TH STREET. SUITE 1 PHOENIX, AZ 85014 | $66K |
| BRADSHAW, SMITH & CO., LLP EIN 88-0150455 NONE | Accounting (including auditing) Service code 10 | 5851 W. CHARLESTON BLVD. LAS VEGAS, NV 89146 | $40K |
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 | 1,024 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,024 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE CO | 910 | $103K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 896 | $734K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 910 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.