| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2375 E CAMELBACK RD, STE 250 PHOENIX, AZ 85016 | BLUE CROSS BLUE SHIELD OF ARIZONA | $78K | — | $78K | 12.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 7535 IRVINE CENTER DRIVE SUITE 250 IRVINE, CA 92618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | $5K | $21K | 7.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 21.80% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $4K | — | $4K | 10.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 NONE | Claims processing; Direct payment from the plan; Contract Administrator; Plan Administrator Service code 12 | — | $306K |
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 | 308 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 308 | $604K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $267K |
| Vision | VISION SERVICE PLAN | 255 | $35K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $267K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $267K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $267K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 308 | $604K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 308 | $604K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 334 | $340K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 334 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.