| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | PO BOX 3430 CARMEL, IN 46082 | BLUE CROSS BLUE SHIELD OF ARIZONA | $57K | $0 | $57K | 16.37% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | PO BOX 3430 CARMEL, IN 46082 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 12.83% |
| CSA GENERAL INSURANCE AGENCY3 | UNKNOWN PHOENIX, AZ 85069 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $534 | $0 | $534 | 4.31% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3900 EAST CAMELBACK ROAD, SUITE 225 PHOENIX, AZ 85018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $934 | $295 | $1K | 13.16% |
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 | 243 | 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) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 131 | $348K |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 131 | $348K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 174 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $9K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.