| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON INSURANCE BROKERS LLC | PO BOX 843844 KANSAS CITY, MO 641843844 | HARTFORD LIFE AND ACCIDENT | — | $10K | $10K | 3.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC. | 4516 E CAMP LOWELL DR TUCSON, AZ 85712 | HARTFORD LIFE AND ACCIDENT | — | $9K | $9K | 3.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC. | 4516 E CAMP LOWELL DR TUCSON, AZ 85712 | DELTA DENTAL OF ARIZONA | $7K | — | $7K | 4.19% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | MICHAEL J HESS PO BOX 17850 DENVER, CO 80217 | DELTA DENTAL OF ARIZONA | $2K | — | $2K | 1.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK, GOULD & ASSOCIATES, INC. | 3800 N CENTRAL AVE 9TH FL PHOENIX, AZ 850121979 | VISION SERVICE PLAN | $1K | — | $1K | 3.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST STE 900 KANSAS CITY, MO 64112 | ALPHA DENTAL OF ARIZONA, INC. | $415 | — | $415 | 4.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC. | 4516 E CAMP LOWELL DR TUCSON, AZ 85712 | ALPHA DENTAL OF ARIZONA, INC. | $405 | — | $405 | 4.48% |
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 | 417 | 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) | 417 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF ARIZONA | 272 | $185K |
| Vision | VISION SERVICE PLAN | 248 | $38K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 417 | $280K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 417 | $280K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 417 | $280K |
| Other | HARTFORD LIFE AND ACCIDENT | 417 | $280K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 417 | — |
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.