| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | BLUE CROSS BLUE SHIELD OF ARIZONA | $4K | $560 | $5K | 2.15% |
| DOW INSURANCE SERVICE INC3 Filed as: DOW INSURANCE SERVICE INC. | 1011 STATE ST STE 210 LEMONT, IL 60439 | BLUE CROSS BLUE SHIELD OF ARIZONA | $2K | $205 | $2K | 1.05% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 8.66% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD OF ARIZONA | 8220 N. 23RD AVENUE PHOENIX, AZ 85021 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $630 | $630 | 3.92% |
| DOW INSURANCE SERVICE INC3 | 1011 STATE ST STE 210 LEMONT, IL 60439 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $499 | — | $499 | 3.11% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 87 | $224K |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 87 | $224K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 112 | $16K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 87 | $224K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 112 | — |
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.