| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 2375 E CAMELBACK RD STE 250 PHOENIX, AZ 85016 | BLUE CROSS BLUE SHIELD OF AZ | $42K | $0 | $42K | 5.18% |
| CREST INSURANCE GROUP LLC3 Filed as: CREST INSURANCE GROUP | 5285 E WILLIAMS CIRCLE STE 4500 TUCSON, AZ 85711 | BLUE CROSS BLUE SHIELD OF AZ | $3K | $0 | $3K | 0.37% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE SUITE 250 IRVINE, CA 92618 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $886 | $6K | 12.73% |
| CREST INSURANCE GROUP LLC3 Filed as: CREST INSURANCE GROUP | 7272 E INDIAN SCHOOL ROAD STE 375 SCOTTSDALE, AZ 85251 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 2.09% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS, LLC | 333 N INDIAN HILL BLVD CLAREMONT, CA 91711 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5 | $0 | $5 | 0.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE CO | $1K | $365 | $2K | 17.70% |
| CREST INSURANCE GROUP LLC3 Filed as: CREST INSURANCE GROUP | 5285 E WILLIAMS CIRCLE STE 4500 TUCSON, AZ 85711 | UNITED OF OMAHA LIFE INSURANCE CO | $107 | $0 | $107 | 1.12% |
| USI INSURANCE SERVICES LLC3 | 2375 E CAMELBACK RD STE 250 PHOENIX, AZ 85016 | HUMANA | $690 | $0 | $690 | 8.67% |
| CREST INSURANCE GROUP LLC3 Filed as: CREST INSURANCE GROUP | 5285 E WILLIAMS CIRCLE STE 4500 TUCSON, AZ 85711 | HUMANA | $117 | $0 | $117 | 1.47% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF AZ | 133 | $804K |
| Dental | BLUE CROSS BLUE SHIELD OF AZ | 133 | $804K |
| Vision | HUMANA | 61 | $8K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 81 | $58K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 39 | $49K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 39 | $49K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF AZ | 133 | $804K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 81 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.