| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK, GOULD & ASSOCIATES | 3800 N CENTRAL 9TH FLOOR PHOENIX, AZ 85012 | BLUE CROSS BLUE SHIELD OF ARIZONA | $30K | — | $30K | 2.92% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BENEFIT COMMERCE GROUP LLC | 14300 NORTH NORTHSIGHT BLVD #221 SCOTTSDALE, AZ 852603677 | BLUE CROSS BLUE SHIELD OF ARIZONA | $21K | — | $21K | 2.03% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK, GOULD & ASSOCIATES | 3800 N CENTRAL 9TH FLOOR PHOENIX, AZ 85012 | COMPANION LIFE INS COMPANY | $4K | — | $4K | 4.62% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BENEFIT COMMERCE GROUP LLC | 14300 NORTH NORTHSIGHT BLVD #221 SCOTTSDALE, AZ 852603677 | COMPANION LIFE INS COMPANY | $1K | — | $1K | 1.26% |
| USI INSURANCE SERVICES LLC | 200 SUMMIT LAKE DRIVE SUITE 350 VALHALLA, NY 10595 | GUARDIAN | $3K | — | $3K | 8.45% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BENEFIT COMMERCE GROUP LLC | 14300 NORTH NORTHSIGHT BLVD #221 SCOTTSDALE, AZ 852603677 | GUARDIAN | $2K | — | $2K | 4.55% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK, GOULD & ASSOCIATES | 3800 N CENTRAL 9TH FLOOR PHOENIX, AZ 85012 | GUARDIAN | $1K | — | $1K | 3.25% |
| WORTHAM SAN ANTONIO INC Filed as: JOHN DRISCOLL & COMPANY INC | 5080 N 40TH STREET #400 PHOENIX, AZ 85018 | GUARDIAN | $31 | — | $31 | 0.09% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK, GOULD & ASSOCIATES | 3800 N CENTRAL 9TH FLOOR PHOENIX, AZ 85012 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $1K | — | $1K | 9.33% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BENEFIT COMMERCE GROUP LLC | 14300 NORTH NORTHSIGHT BLVD #221 SCOTTSDALE, AZ 852603677 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $327 | — | $327 | 2.87% |
| CSA GENERAL INSURANCE AGENCY Filed as: CSA GEN INSURANCE AGENCY | 2480 WEST LAS PALMARITAS DR PHOENIX, AZ 85021 | COMPANION LIFE INS COMPANY | $784 | $5 | $789 | 20.13% |
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 | 135 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 108 | $1.0M |
| Dental | COMPANION LIFE INS COMPANY | 225 | $94K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 204 | $1.0M |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 135 | $38K |
| Short-term disability | GUARDIAN | 57 | $34K |
| Long-term disability | GUARDIAN | 57 | $34K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 108 | $1.0M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 135 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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.