| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | BLUE CROSS BLUE SHIELD OF ARIZONA | $33K | — | $33K | 4.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | P.O. BOX 730054 DALLAS, TX 75373 | UNITED CONCORDIA INSURANCE COMPANY | $3K | — | $3K | 6.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON WEST INC | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 7.52% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | — | $186 | $186 | 0.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON WEST INC | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94150 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 16.00% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | — | $7 | $7 | 0.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON WEST INC | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 13.09% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | — | $6 | $6 | 0.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | P.O. BOX 730054 DALLAS, TX 75373 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $901 | — | $901 | 10.68% |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 140 | $671K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 146 | $55K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 127 | $8K |
| Life insurance | STANDARD INSURANCE COMPANY | 107 | $40K |
| Short-term disability | STANDARD INSURANCE COMPANY | 14 | $9K |
| Long-term disability | STANDARD INSURANCE COMPANY | 14 | $11K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 140 | $671K |
| Other | STANDARD INSURANCE COMPANY | 107 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.