| 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 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $24K | — | $24K | 11.17% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 4.44% |
| SETH G KNOWLTON3 | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 2.18% |
| NICHOLAS CAFFREY3 | 6502 N CALLE LOTTIE TUCSON, AZ 857181903 | CONTINENTAL AMERICAN INSURANCE COMPANY | $667 | — | $667 | 1.42% |
| KELLY MCGARRY3 | 8785 N MOONFIRE DR TUCSON, AZ 85743 | CONTINENTAL AMERICAN INSURANCE COMPANY | $395 | — | $395 | 0.84% |
| RACHEL DAY3 Filed as: RACHEL S DAY | 5533 E 24TH ST TUCSON, AZ 85711 | CONTINENTAL AMERICAN INSURANCE COMPANY | $247 | — | $247 | 0.53% |
| JILL N NEMODE3 | 3173 E HATTUCK SAGINAW, MI 48603 | CONTINENTAL AMERICAN INSURANCE COMPANY | $93 | — | $93 | 0.20% |
| KIMBERLY RODRIGUEZ3 Filed as: KIMBERLY JOY GRAHAM RODRIGUEZ | 37057 S GAMBEL QUAIL DR MARANA, AZ 85658 | CONTINENTAL AMERICAN INSURANCE COMPANY | $45 | — | $45 | 0.10% |
| MATTHEW THOMAS NEMODE3 Filed as: MATTHEW T NEMODE | 3985 KAWKAWLIN RIVER DR BAY CITY, MI 48706 | CONTINENTAL AMERICAN INSURANCE COMPANY | $34 | — | $34 | 0.07% |
| KAYELA FORD3 Filed as: KAYELA A FORD | 976 YESTERDAY LANE MEDINA, OH 44256 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | — | $17 | 0.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $45 | — | $45 | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 TPA | Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Consulting (general); Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 12 | — | $390K |
| CBIZ BENEFITS & INS SERVICES BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions; Non-monetary compensation; Other fees Service code 22 | PO BOX 632886 CINCINNATI, OH 45263 | $20K |
| PRUDENTIAL INSURANCE COMPANY EIN 22-1211670 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $19K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $18K |
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 | 416 | 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) | 416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 330 | $58K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 416 | $217K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 100 | $47K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 416 | $217K |
| Other(2 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 416 | $219K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 416 | — |
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."
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.