| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST SUITE 1100 KANSAS CITY, ME 64112 | AMERITAS LIFE INSURANCE CORP | $4K | $4K | $7K | 4.04% |
| KIMBERLY RODRIGUEZ3 | 37057 S GAMBEL QUAIL DR MARANA, AZ 85658 | AFLAC | $7K | $416 | $7K | 12.19% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $4K | — | $4K | 6.84% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $3K | $181 | $3K | 4.70% |
| RACHEL DAY3 | 5533 E 24TH STREET TUCSON, AZ 85711 | AFLAC | $2K | $203 | $3K | 4.40% |
| NADIA ANDRE3 | 12880 W. SHERIDAN ST AVONDALE, AZ 85392 | AFLAC | $1K | $170 | $1K | 2.57% |
| TREVOR BRYAN DAVIS3 | 9160 E. LOMA LINDA PL. TUCSON, AZ 85749 | AFLAC | $1K | $160 | $1K | 2.11% |
| JARCEY RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $579 | $11 | $590 | 1.03% |
| ALICIA MOISES3 | PO BOX 30041 TUCSON, AZ 85751 | AFLAC | $294 | $66 | $360 | 0.63% |
| MARGARET WRIGHT3 | 7049 E TANQUE VERDE RD STE 114 TUCSON, AZ 85715 | AFLAC | $220 | $38 | $258 | 0.45% |
| WILLAM KEYS3 | 2429 CLARKE PLZ LAKE HAVASU, AZ 86403 | AFLAC | $214 | $12 | $226 | 0.39% |
| CATHERINE DAVIS3 | 9160 E LOMA LINDA PL TUCSON, AZ 85749 | AFLAC | $117 | $33 | $150 | 0.26% |
| MARK MCDANIEL3 | 11928 HIGHWAY 62 FORT GIBSON, OK 74434 | AFLAC | $144 | — | $144 | 0.25% |
| LAUREL L HARLOW3 Filed as: LAUREL HARLOW | 6200 W ROAN PLACE TUCSON, AZ 85743 | AFLAC | $113 | $13 | $126 | 0.22% |
| ZAKERY HARLOW3 | 2960 N ACADEMY BLVD STE 101 COLORADO SPRINGS, CO 80917 | AFLAC | $93 | $13 | $106 | 0.18% |
| RICK M MCKINNEY3 Filed as: RICK MCKINNEY | PO BOX 26132 COLORADO SPRINGS, CO 80936 | AFLAC | $82 | $11 | $93 | 0.16% |
| MARIA MULLIGAN3 | 24654 N PLEASANT PKWY 103-417 PEORIA, AZ 85383 | AFLAC | $46 | $19 | $65 | 0.11% |
| DAVID R LATTIMER3 Filed as: DAVID LATTIMER | 3029 N SONORAN HILLS MESA, AZ 85207 | AFLAC | $56 | — | $56 | 0.10% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT AND TOUCHE INC | PO BOX 32702 TUCSON, AZ 85751 | AFLAC | $50 | — | $50 | 0.09% |
| ALEXANDRA JACOBI3 Filed as: ALEXANDRA C DIBIASI LLC | PO BOX 72105 PHOENIX, AZ 85050 | AFLAC | $20 | $4 | $24 | 0.04% |
| SCOTT WEBB3 | 12366 W MILTON DR PERIA, AZ 85383 | AFLAC | $23 | — | $23 | 0.04% |
| MARK HILL3 | PO BOX 85715 TUCSON, AZ 85754 | AFLAC | $21 | — | $21 | 0.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE RD SUITE 600 SCOTTSDALE, AZ 85254 | AFLAC | $20 | — | $20 | 0.03% |
| JENNIFER GOOCH3 | 4897 W. HURSTON DR. TUCSON, AZ 85742 | AFLAC | $17 | — | $17 | 0.03% |
| MICHAEL ARTHUR KIRK3 Filed as: MICHAEL KIRK | 4150 S 100TH EAST AVE STE 101 TULSA, OK 74146 | AFLAC | $17 | — | $17 | 0.03% |
| GLEN GABLE3 | 3521 S CAMELLIA PL CHANDLER, AZ 85248 | AFLAC | $16 | — | $16 | 0.03% |
| MICHAEL FATHERREE3 | 171 COUNTRY RD 1559 ALBA, TX 75410 | AFLAC | $16 | — | $16 | 0.03% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT GUTHRIE | 14227 N 14TH ST PHOENIX, AZ 85022 | AFLAC | $11 | $4 | $15 | 0.03% |
| SCOTT WOOD3 Filed as: SCOTT KOSTEL | 9566 E WINDROSE DR. SCOTTSDALE, AZ 85260 | AFLAC | $11 | — | $11 | 0.02% |
| ASPEN COVE-DASTRUP INSURANCE INC3 Filed as: ASPEN COVE INSURANCE INC | 4844 N 300 W STE 100 PROVO, UT 84604 | AFLAC | $11 | — | $11 | 0.02% |
| DONNA NORTHRUP3 | 3501 N FREEWAY SPC 65 TUCSON, AZ 85705 | AFLAC | $10 | — | $10 | 0.02% |
| MELISSA B BOYLE3 Filed as: MELISSA BOYLE | 6300 E HAMPDEN AVE STE C101 DENVER, CO 80222 | AFLAC | $10 | — | $10 | 0.02% |
| ANGELONE & ASSOCIATES, INC.3 Filed as: ANGELONE & ASSOCIATES INC | 14300 N NORTHSIGHT BLVD STE 221 SCOTTSDALE, AZ 85260 | AFLAC | $9 | — | $9 | 0.02% |
| EXEL IVAN CARABALLO JR3 Filed as: EXEL CARABALLO JR | 2329 E BOWKET ST. PHOENIX, AZ 85040 | AFLAC | $8 | — | $8 | 0.01% |
| PAMELA UTTER3 | 7750 W BOCA RATON RD PEORIA, AZ 85381 | AFLAC | $8 | — | $8 | 0.01% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR STE 291 MOUNT PLEASANT, WI 53406 | AFLAC | $8 | — | $8 | 0.01% |
| LESLIE J BAILEY3 Filed as: LESLIE BAILEY | 4234 N PORTAGE AVE MERIDAIN, ID 83646 | AFLAC | $5 | — | $5 | 0.01% |
| PALOMAR INSURANCE CORPORATION3 Filed as: PALOMAR INS CORP | 4525 EXECUTIVE PARK DR SUITE 202 MONTGOMERY, AL 36116 | AFLAC | $5 | — | $5 | 0.01% |
| MULLIGAN BENEFITS LLC3 | 24654 N LAKE PLEASANT PKWY 103-417 PEORIA, AZ 85383 | AFLAC | $5 | — | $5 | 0.01% |
| SHAWN HOLTORF3 | 5522 W NORTHWOOD DR. GLENDALE, AZ 85310 | AFLAC | $4 | — | $4 | 0.01% |
| ROBERT LABONTE3 | 1659 W SAN REMO ST GILBERT, AZ 85233 | AFLAC | $4 | — | $4 | 0.01% |
| JEFFERY S GIBSON3 Filed as: JEFFERY GIBSON | 3009 HUNTON COTTAGE LANE GLEN ALLEN, VA 23059 | AFLAC | $4 | — | $4 | 0.01% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $4 | — | $4 | 0.01% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 360 W HUBBARD ST APT 1105 CHICAGO, IL 60654 | AFLAC | $4 | — | $4 | 0.01% |
| C SKIPPER3 | PO BOX 11128 MONTGOMERY, AL 36111 | AFLAC | $3 | — | $3 | 0.01% |
| SANDRA L SARFF3 Filed as: SANDRA SARFF | 7090 N ORACLE RD PMB 152 TUCSON, AZ 85704 | AFLAC | $3 | — | $3 | 0.01% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 3420 E SHEA BLVD. STE 168 PHOENIX, AZ 85028 | AFLAC | $2 | — | $2 | 0.00% |
| NATALIE MALHAM3 | 3850 E BASELINE RD STE 116 MESA, AZ 85206 | AFLAC | $2 | — | $2 | 0.00% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD STE 116 MESA, AZ 85206 | AFLAC | $2 | — | $2 | 0.00% |
| ANDREW SIMMONS3 | 5421 VILLA TRCE HOOVER, AL 35244 | AFLAC | $2 | — | $2 | 0.00% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 4910 CORPRATE DR. NW STE G HUNTSVILLE, AL 35805 | AFLAC | $2 | — | $2 | 0.00% |
| SHARON MCKELVEY3 | 197 N NOTTINGHAM LANE LOT 3 PAYSON, AZ 85541 | AFLAC | $2 | — | $2 | 0.00% |
| VINCENT TAYLOR ECHOLS3 Filed as: VINCENT ECHOLS | PO BOX 594 THATCHER, AZ 85552 | AFLAC | $2 | — | $2 | 0.00% |
| BETTY JEAN GAMACHE3 Filed as: BETTY GAMACHE | 136 CHARLESTON CT N MONTGOMERY, AL 36117 | AFLAC | $2 | — | $2 | 0.00% |
| MARSHA L ECHOLS3 Filed as: MARSHA ECHOLS | PO BOX 594 THATCHER, AZ 85552 | AFLAC | $2 | — | $2 | 0.00% |
| JUSTIN WAYNE ECHOLS3 Filed as: JUSTIN ECHOLS | PO BOX 1283 THATCHER, AZ 85552 | AFLAC | $2 | — | $2 | 0.00% |
| KEITH BELICH3 | 8650 MINNIE BROWN RD STE 150 MONTGOMERY, AL 36117 | AFLAC | $1 | — | $1 | 0.00% |
| SUSAN MULLIGAN3 | 818 S MANN AVE TUCSON, AZ 85710 | AFLAC | $1 | — | $1 | 0.00% |
| TOM KOCH3 | 1800 NE 48TH CT FT LAUDERDALE, FL 33308 | AFLAC | $1 | — | $1 | 0.00% |
| JOHN W AMOS3 Filed as: JOHN AMOS | 4245 MILGEN RD COLUMBUS, GA 31907 | AFLAC | $1 | — | $1 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $3K | $14K | 24.52% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $2K | $12K | 24.93% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 14.69% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 14.59% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $1K | — | $1K | 4.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $114K |
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 | 569 | 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) | 569 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP | 569 | $184K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP | 569 | $217K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 313 | $91K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 127 | $106K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 313 | $47K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 313 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 569 | — |
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.