| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK J MATSOCK3 Filed as: MARK MATSOCK | 2400 E AZ BILTMORE CIRCLE #1100 PHOENIX, AZ 85016 | KAISER FOUNDATION HEALTH PLAN INC | $34K | — | $34K | 1.93% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 2400 E AZ BILTMORE CIRCLE #1100 PHOENIX, AZ 85016 | CIGNA HEALTH AND LIFE INSRUANCE COMPANY | $13K | — | $13K | 9.89% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | CIGNA HEALTH AND LIFE INSRUANCE COMPANY | — | $5K | $5K | 3.95% |
| MARK J MATSOCK3 | 2400 E AZ BILTMORE CIRCLE #1100 PHOENIX, AZ 85016 | VISION SERVICE PLAN | $1K | — | $1K | 6.50% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 2400 E AZ BILTMORE CIRCLE #1100 PHOENIX, AZ 85016 | CIGNA DENTAL HEALTH OF CALIFORNIA INC | $890 | — | $890 | 10.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | CIGNA DENTAL HEALTH OF CALIFORNIA INC | — | $356 | $356 | 4.00% |
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 | 217 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 275 | $1.8M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSRUANCE COMPANY | 218 | $138K |
| Vision | VISION SERVICE PLAN | 116 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.