| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | DELTA DENTAL OF ARIZONA | $11K | $0 | $11K | 7.48% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 7.30% |
| CSA GENERAL INSURANCE AGENCY3 | UNKNOWN PHOENIX, AZ 85069 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $5K | $0 | $5K | 15.34% |
| USI INSURANCE SERVICES LLC3 | 2375 EAST CAMELBACK ROAD SUITE 250 PHOENIX, AZ 85016 | EMPLOYERS DENTAL SERVICES | $1K | $0 | $1K | 7.94% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 29.27% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 EAST DOUBLETREE RANCH ROAD SUITE C-103 SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $890 | $0 | $890 | 6.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | PO BOX 844663 DALLAS, TX 75284 | TRANSAMERICA LIFE INSURANCE COMPANY | $113 | $0 | $113 | 0.89% |
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 | 380 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 380 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF ARIZONA | 205 | $159K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 344 | $31K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 463 | $86K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 463 | $86K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 463 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 463 | — |
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.