| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC. | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNITED HEALTHCARE INSURANCE COMPANY | $19K | — | $19K | 4.08% |
| AMCHECK NATIONAL BROKER SERV. CORP.3 Filed as: AMCHECK NATIONAL BROKER SERVICES | 5030 E. SUNRISE DR. PHOENIX, AZ 85044 | UNITED HEALTHCARE INSURANCE COMPANY | $513 | — | $513 | 0.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES, INC. | 3800 N. CENTRAL AVE., 9TH FLOOR PHOENIX, AL 85012 | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | $9K | — | $9K | 11.29% |
| AMCHECK NATIONAL BROKER SERV. CORP.3 | 5030 E. SUNRISE DR. PHOENIX, AZ 85044 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | — | $2K | 14.13% |
| WINSTON FINANCIAL SERVICES3 Filed as: WINSTON FINANCIAL SERVICES, INC. | 1705 BAY AVE POINT PLEASANT, NJ 08742 | TRANSAMERICA LIFE INSURANCE COMPANY | $1K | — | $1K | 8.02% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 E. DOUBLETREE RANCH ROAD SUITE C103 SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $312 | — | $312 | 2.03% |
| RAYMOND HEBERT3 | 13882 E. LAUREL LANE SCOTTSDALE, AZ 85259 | AFLAC | $201 | — | $201 | 6.68% |
| PETER LEMIEUX AGENCY, INC.3 | 3751 S. VELERO STREET CHANDLER, AZ 85286 | AFLAC | $47 | — | $47 | 1.56% |
| SHAWN HOLTORF3 | 5522 W. NORTHWOOD DRIVE GLENDALE, AZ 85310 | AFLAC | $43 | — | $43 | 1.43% |
| SCOTT WEBB3 | 26729 N. 91 ST. DR. PEORIA, AZ 85383 | AFLAC | $18 | — | $18 | 0.60% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 1 W SUPERIOR ST., APT 1301 CHICAGO, IL 60654 | AFLAC | $5 | — | $5 | 0.17% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR. | 3420 E. SHEA BLVD., SUITE 188 PHOENIX, AZ 85028 | AFLAC | $2 | — | $2 | 0.07% |
| TIMOTHY MARTIN3 | 20516 N. 80TH LANE PEORIA, AZ 85382 | AFLAC | $2 | — | $2 | 0.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GERBER LIFE EIN 13-2611847 REINSURANCE CARRIER | Other commissions Service code 55 | 1311 MAMARONECK AVE WHITE PLAINS, NY 10605 | $179K |
| THE BENEFIT GROUP EIN 47-0720154 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 11906 ARBOR STREET, SUITE 100 OMAHA, NE 68144 | $28K |
| AMCHECK NATIONAL BROKERAGE SERVICES EIN 20-3794829 BROKER | Insurance agents and brokers Service code 22 | 5030 E SUNRISE DR. PHOENIX, AZ 85044 | $24K |
| PHCS/MULTIPLAN EIN 13-3068979 PPO NETWORK | Other commissions Service code 55 | PO BOX 29380 GENERAL POST OFFICE NEW YORK, NY 10087 | $6K |
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 | 159 | 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) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 109 | $454K |
| Dental | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | 159 | $83K |
| Life insurance | TRANSAMERICA LIFE INSURANCE COMPANY | 238 | $15K |
| Short-term disability(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 238 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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.