| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAYELA MAJOROS3 | 11273 W ROCK ART DR MARANA, AZ 85658 | AFLAC | $5K | $644 | $6K | 8.62% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $4K | — | $4K | 5.89% |
| KAYELA MAJOROS3 | 3201 E FORT LOWELL RD APT 2068 TUCSON, AZ 85716 | AFLAC | $3K | $328 | $4K | 5.43% |
| KELLY MCGARRY3 | 4750 N ORACLE RD. SUITE 214 TUCSON, AZ 85705 | AFLAC | $3K | $28 | $3K | 4.12% |
| TIFFANY FORD3 | 232 W PASEO CELESTIAL SAHUARITA, AZ 85629 | AFLAC | $1K | $45 | $1K | 2.25% |
| ANGELICA JASMINE LOPEZ3 | 1455 N CALLE ZAMORA ORACLE, AZ 85623 | AFLAC | $748 | — | $748 | 1.14% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $552 | $28 | $580 | 0.88% |
| HELEN HAGARDT3 | 9076 N IRONWOOD MEADOWS DR TUCSON, AZ 85742 | AFLAC | $450 | — | $450 | 0.68% |
| RACHEL DAY3 | 5533 E 24TH ST TUCSON, AZ 85711 | AFLAC | $402 | $39 | $441 | 0.67% |
| M & O AGENCIES INC3 | 1835 S EXTENSION RD MESA, AZ 85210 | AFLAC | $222 | — | $222 | 0.34% |
| ANGEL ANDRES ROMO3 | 1034 E HAMPTON ST TUCSON, AZ 85719 | AFLAC | $214 | — | $214 | 0.33% |
| GAIL PARSON3 | 750 W ORANGE GROVE RD APT 24101 TUCSON, AZ 85704 | AFLAC | $135 | $38 | $173 | 0.26% |
| SANDRA L SARFF3 Filed as: SANDRA SARFF | 7090 N ORACLE RD PMB 152 TUCSON, AZ 85704 | AFLAC | $68 | — | $68 | 0.10% |
| MARK HILL3 | 5188 E PARK VISTA DR. TUCSON, AZ 85756 | AFLAC | $68 | — | $68 | 0.10% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 4470 WOODMAN AVE UNIT 303 SHERMAN OAKS, CA 91423 | AFLAC | $35 | — | $35 | 0.05% |
| SANDRA L SARFF3 | 3811 E CHICO LN TUCSON, AZ 85739 | AFLAC | $34 | — | $34 | 0.05% |
| JOHN PATTON3 | 13497 EAGLE NEST CT CORONA, CA 92880 | AFLAC | $34 | — | $34 | 0.05% |
| ZAKERY ALLEN HARLOW3 | 2030 W BASELINE ROAD SUITE 182-17062 PHOENIX, AZ 85041 | AFLAC | $33 | — | $33 | 0.05% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $33 | — | $33 | 0.05% |
| DAVID R LATTIMER3 | 6605 N 93RD AVE GLENDALE, AZ 85305 | AFLAC | $32 | — | $32 | 0.05% |
| CATHERINE DAVIS3 | 9160 E LOMA LINDA PL TUCSON, AZ 85749 | AFLAC | $27 | — | $27 | 0.04% |
| SARA BRIERY3 | 4 MARBURG LANE SAVANNAH, GA 31411 | AFLAC | $27 | — | $27 | 0.04% |
| CHEYANNA SARFF3 | 3737 W CROMWELL DR. TUCSON, AZ 85741 | AFLAC | $21 | — | $21 | 0.03% |
| DAVID R LATTIMER3 Filed as: DAVID LATTIMER | 3029 N SORORAN HILLS MESA, AZ 85207 | AFLAC | $19 | — | $19 | 0.03% |
| MICHAEL FATHERREE3 | 171 COUNTY ROAD 1559 ALBA, TX 75410 | AFLAC | $19 | — | $19 | 0.03% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | 160 SANTA CLARA ST STE 450 SAN JOSE, CA 95113 | AFLAC | $19 | — | $19 | 0.03% |
| JEREMY MICHAEL PETERSON3 | 1319 E EDISON ST TUCSON, AZ 85719 | AFLAC | $18 | — | $18 | 0.03% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LN PHOENIX, AZ 85042 | AFLAC | $16 | — | $16 | 0.02% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $14 | — | $14 | 0.02% |
| SCOTT WEBB3 | 26729 N 91ST DR PEORIA, AZ 85383 | AFLAC | $13 | — | $13 | 0.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $9 | — | $9 | 0.01% |
| JEANETTE FATHERREE3 | 171 COUNTY RD. 1559 ALBA, TX 75410 | AFLAC | $2 | — | $2 | 0.00% |
| JOHN BURLEY3 | 3989 W ORANGEWOOD DR TUCSON, AZ 85741 | AFLAC | $2 | — | $2 | 0.00% |
| JEFFERY KLEINMAN SR3 | 33202 N 46TH WAY CAVE CREEK, AZ 85331 | AFLAC | $2 | — | $2 | 0.00% |
| SHARON MCKELVEY3 | 197 N NOTTINGHAM LN LOT 3 PAYSON, AZ 85541 | AFLAC | $1 | — | $1 | 0.00% |
| LAUREL L HARLOW3 Filed as: LAUREL HARLOW | 2030 W BASELINE RD STE 182 PHOENIX, AZ 85041 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD STE 116 MESA, AZ 85206 | AFLAC | $1 | — | $1 | 0.00% |
| NATALIE MALHAM3 | 5822 N 13TH ST PHOENIX, AZ 85014 | AFLAC | $1 | — | $1 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $368 | $2K | 9.56% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | EMPLOYERS DENTAL SERVICES | $557 | — | $557 | 5.93% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | AETNA LIFE INSURANCE CO. | $629 | $2K | $3K | 48.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CBIZ BENEFITS & INS SERVICES INC. EIN 31-1582098 BROKER | Insurance agents and brokers Service code 22 | PO BOX 632886 CINCINNATI, OH 45263 | $33K |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BANNER HEALTH AND AETNA HEALTH | 122 | $624K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 64 | $28K |
| Vision | AETNA LIFE INSURANCE CO. | 98 | $6K |
| Short-term disability | AFLAC | 94 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.