| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITMALL3 | 2111 E. HIGHLAND AVE PHOENIX, AZ 85016 | THE UNION LABOR LIFE INSURANCE COMPANY | $6K | — | $6K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELFARE & PENSION ADMIN SVCS, INC. EIN 91-1363171 NONE | Accounting (including auditing); Claims processing; Other services; Plan Administrator; Direct payment from the plan; Contract Administrator Service code 10 | — | $756K |
| RAEL & LETSON EIN 94-1701048 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $111K |
| BARLOW COUGHRAN MORALES & JOSEPHSON EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $102K |
| WASHINGTON CAPITAL MANAGEMENT, INC EIN 91-1042342 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $58K |
| ANASTASI, MOORE & MARTIN PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $33K |
| BANK OF AMERICA EIN 94-1687765 NONE | Direct payment from the plan; Other services Service code 49 | — | $30K |
| NATIONAL COOPERATIVE RX EIN 04-3775178 NONE | Other fees Service code 99 | — | $30K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $26K |
| US BANK N.A. EIN 31-0841368 NONE | Custodial (securities); Direct payment from the plan; Soft dollars commissions Service code 19 | — | $19K |
| KEVIN DOLAN TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | 7525 SE 24TH ST #200 MERCER ISLAND, WA 98040 | $11K |
| CVS CAREMARK EIN 05-0340626 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $9K |
| TODD TAYLOR TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | 7525 SE 24TH #200 MERCER ISLAND, WA 98040 | $8K |
| CHANGE HEALTHCARE EIN 20-5731067 NONE | Direct payment from the plan; Other services Service code 49 | — | $8K |
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 | 1,304 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 381 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,681 | $291K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,681 | — |
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.