| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 4.97% |
| SETH G KNOWLTON3 Filed as: SETH GEORGE KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 4.46% |
| KELLY MCGARRY3 | 8785 N MOONFIRE DR TUCSON, AZ 85743 | CONTINENTAL AMERICAN INSURANCE COMPANY | $500 | — | $500 | 0.77% |
| RACHEL DAY3 Filed as: RACHEL SUE DAY | 5533 E 24TH ST TUCSON, AZ 85711 | CONTINENTAL AMERICAN INSURANCE COMPANY | $409 | — | $409 | 0.63% |
| KIMBERLY J RODRIQUEZ3 Filed as: KIMBERLY JOY GRAHAM | 37057 S GAMBEL QUAIL DR MARANA, AZ 85658 | CONTINENTAL AMERICAN INSURANCE COMPANY | $220 | — | $220 | 0.34% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 34.29% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 6.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $668 | — | $668 | 6.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $428 | — | $428 | 6.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $507 | — | $507 | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $229 | — | $229 | 6.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $134 | — | $134 | 6.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $30 | — | $30 | 3.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $46 | — | $46 | 5.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Other fees; Insurance services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Direct payment from the plan Service code 12 | — | $307K |
| CBIZ BENEFITS & INS SERVICES BROKER | Insurance agents and brokers; Non-monetary compensation; Insurance brokerage commissions and fees; Other commissions; Other fees Service code 22 | PO BOX 632886 CINCINNATI, OH 45263 | $25K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $15K |
| PRUDENTIAL INSURANCE COMPANY EIN 22-1211670 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $9K |
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 | 386 | 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) | 386 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 310 | $67K |
| Life insurance(8 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 386 | $189K |
| Short-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 359 | $66K |
| Long-term disability(3 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 166 | $54K |
| Other(4 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 386 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 386 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.