| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 14300 N NORTHSIGHT BLVD STE 221 SCOTTSDALE, AZ 85260 | BLUE CROSS BLUE SHIELD OF ARIZONA | $19K | — | $19K | 4.19% |
| CREST INSURANCE GROUP LLC3 | 5285 E WILLIAMS CIRCLE STE 4500 TUCSON, AZ 85711 | BLUE CROSS BLUE SHIELD OF ARIZONA | $2K | — | $2K | 0.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 14300 N. NORTHSIGHT BLVD STE 221 SCOTTSDALE, AZ 85260 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 5.99% |
| CREST INSURANCE GROUP LLC3 Filed as: CREST INS GROUP LLC | 7272 E. INDIAN SCHOOL ROAD STE 375 SCOTTSDALE, AZ 85251 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $176 | — | $176 | 0.42% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DRISCOLL & COMPANY INC | 5080 N 40TH ST #400 PHOENIX, AZ 85018 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $60 | — | $60 | 0.14% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $31 | — | $31 | 0.07% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DRISCOLL & COMPANY INC | 5080 N 40TH ST #400 PHOENIX, AZ 85018 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4 | — | $4 | 0.01% |
| CSA GENERAL INS AGENCY INC3 | 2480 WEST LAS PALMARITAS DR. PHOENIX, AZ 85021 | COMPANION LIFE INSURANCE COMPANY | $1K | $5 | $1K | 20.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 14300 NORTHSIGHT BLVD SUITE 221 SCOTTSDALE, AZ 85260 | AETNA LIFE INSURANCE CO. | $526 | — | $526 | 9.41% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 85 | $443K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 55 | $42K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 85 | $449K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 199 | $48K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 85 | $443K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 199 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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.
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.