| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 Filed as: EMPLOYEE BENEFITS INT. AZ., INC. | 7901 NORTH 16TH STREET, SUITE 200 PHOENIX, AZ 85020 | BLUE CROSS BLUE SHIELD OF ARIZONA | $28K | $0 | $28K | 4.74% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 Filed as: EMPLOYEE BENEFITS INT. AZ., INC. | 8828 NORTH CENTRAL AVENUE SUITE 100 PHOENIX, AZ 85020 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $2K | $13K | 13.68% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KOGER AVENUE, SUITE 200 SAINT PETERSBURG, FL 33702 | METLIFE LEGAL PLANS | $278 | $0 | $278 | 27.36% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 Filed as: EMPLOYEE BENEFITS INT. AZ., INC. | 8828 NORTH CENTRAL AVENUE SUITE 100 PHOENIX, AZ 85020 | METLIFE LEGAL PLANS | $153 | $0 | $153 | 15.06% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFIT ADMIN., INC. | PO BOX 9201 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | $0 | $76 | $76 | 7.48% |
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 | 648 | 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) | 648 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 80 | $601K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 131 | $92K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 131 | $92K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 131 | $92K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 80 | $601K |
| Other(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 542 | $713K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 542 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.