| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VICTORIA STEPHENS3 | 8110 S HOUGHTON RD STE 158-198 TUCSON, AZ 95747 | BLUE CROSS BLUE SHIELD OF ARIZONA | — | $300 | $300 | 0.04% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF ARIZONA LLC | 4544 E CAMP LOWELL DR STE 1140 TUCSON, AZ 85712 | BLUE CROSS BLUE SHIELD OF ARIZONA | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROWN & BROWN OF WA DBA DIMARTINO A EIN 91-0378940 NONE | Consulting (general) Service code 16 | — | $25K |
| CREST INSURANCE GROUP, LLC NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 5285 E WILLIAMS CIRCLE, SUITE 4500 TUCSON, AZ 85711 | $15K |
| VIMLY BENEFIT SOLUTIONS, INC. EIN 91-1603312 NONE | Plan Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing) Service code 10 | — | $11K |
| VICTORIA STEPHENS NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 8110 S HOUGHTON RD 158-198 TUCSON, AZ 85747 | $7K |
| MAGNUSON & ASSOCIATES LTD NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 4337 E 5TH STREET TUCSON, AZ 85711 | $6K |
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 | 111 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 159 | $674K |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 159 | $674K |
| Vision | VISION SERVICE PLAN | 17 | $1K |
| Life insurance | STANDARD INSURANCE COMPANY | 58 | $4K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 159 | $674K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.