| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS ALLEN GIBSON3 | 16837 SOUTH 18TH WAY PHOENIX, AZ 85048 | BLUE CROSS BLUE SHIELD OF ARIZONA | $44K | — | $44K | 2.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N. CENTRAL AVENUE PHOENIX, AZ 85012 | BLUE CROSS BLUE SHIELD OF ARIZONA | $20 | — | $20 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N. CENTRAL AVENUE PHOENIX, AZ 85012 | UNITED HEALTHCARE INSURANCE COMPANY | -$4 | — | -$4 | -0.01% |
| THOMAS ALLEN GIBSON3 | 16837 S 18TH WAY PHOENIX, AZ 85048 | UNITED HEALTHCARE INSURANCE COMPANY | -$9 | — | -$9 | -0.01% |
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 | 261 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 186 | $1.6M |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 186 | $1.6M |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 261 | $72K |
| Life insurance | UNITED HEALTHCARE INSURANCE COMPANY | 261 | $72K |
| Short-term disability | UNITED HEALTHCARE INSURANCE COMPANY | 261 | $72K |
| Long-term disability | UNITED HEALTHCARE INSURANCE COMPANY | 261 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.