| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CREST INSURANCE GROUP LLC3 | 5285 E WILLIAMS CIR SUITE 4500 TUCSON, AZ 85711 | BLUE CROSS BLUE SHIELD OF ARIZONA | $30K | $0 | $30K | 4.65% |
| CREST INSURANCE GROUP LLC3 Filed as: CREST INSURANCE GROUP, LLC | 5285 E WILLIAMS CIR SUITE 4500 TUCSON, AZ 85711 | DELTA DENTAL OF ARIZONA | $5K | $0 | $5K | 5.15% |
| CREST INSURANCE GROUP LLC3 | 5285 E WILLIAMS CIR SUITE 4500 TUCSON, AZ 85711 | MONY LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 15.00% |
| AXA ASSISTANCE, USA3 Filed as: BCBS OF AZ - AXA | 2444 W LAS PALMARITAS DR PHOENIX, AZ 85021 | MONY LIFE INSURANCE COMPANY OF AMERICA | $0 | $531 | $531 | 7.49% |
| ROGER BENEFIT GROUP INC3 Filed as: ROGER BENEFIT GROUP | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | MONY LIFE INSURANCE COMPANY OF AMERICA | $0 | $354 | $354 | 5.00% |
No Schedule C service providers reported on this filing.
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 | 273 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 101 | $650K |
| Dental | DELTA DENTAL OF ARIZONA | 102 | $98K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 102 | $749K |
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 273 | $7K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 101 | $650K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.