| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS INTERNATIONAL3 | 8828 NORTH CENTRAL AVENUE SUITE 100 PHOENIX, AZ 85020 | HARTFORD LIFE AND ACCIDENT | $7K | $2K | $9K | 13.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $1K | $0 | $1K | 1.84% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | 8828 NORTH CENTRAL AVENUE SUITE 100 PHOENIX, AZ 85020 | DELTA DENTAL OF ARIZONA | $5K | — | $5K | 10.74% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | 8828 NORTH CENTRAL AVENUE SUITE 1000 PHOENIX, AZ 85020 | DELTA DENTAL OF ARIZONA | $919 | — | $919 | 10.66% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KOGER AVENUE, SUITE 200 SAINT PETERSBURG, FL 33702 | METLIFE LEGAL PLANS | $747 | $0 | $747 | 20.27% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | $369 | $187 | $556 | 15.08% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | 8828 NORTH CENTRAL AVENUE SUITE 100 PHOENIX, AZ 85020 | METLIFE LEGAL PLANS | $341 | $0 | $341 | 9.25% |
| GIS OF ILLINOIS3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METLIFE LEGAL PLANS | $60 | $0 | $60 | 1.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8 CADILLAC DRIVE, SUITE 200 BRENTWOOD, TN 37027 | METLIFE LEGAL PLANS | $27 | $0 | $27 | 0.73% |
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 | 93 | 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) | 93 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ARIZONA | 106 | $48K |
| Vision | DELTA DENTAL OF ARIZONA | 102 | $9K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 93 | $64K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 93 | $64K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 93 | $64K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 93 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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.