| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC | 7202 E ROSEWOOD ST STE 200 TUCSON, AZ 85710 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $26K | $0 | $26K | 12.99% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $11K | $11K | 5.20% |
| MARSH & MCLENNAN AGENCY LLC3 | 7202 E ROSEWOOD ST STE 200 TUCSON, AZ 85710 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $4K | $14K | 12.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 4.66% |
| MARSH & MCLENNAN AGENCY LLC | 7202 E ROSEWOOD ST STE 200 TUCSON, AZ 85710 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | $0 | $7K | 15.59% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $3K | $3K | 6.24% |
| MARSH & MCLENNAN AGENCY LLC Filed as: MARSH & MCLENNAN INSURANCE AGENCIES | 9171 TOWNE CENTRE DR #100 SAN DIEGO, CA 92122 | DELTA DENTAL OF ARIZONA | $3K | $0 | $3K | 7.62% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | DELTA DENTAL OF ARIZONA | $929 | $0 | $929 | 2.39% |
| LOVITT AND TOUCHE, INC. Filed as: LOVITT TOUCHE, INC. | PO BOX 32702 SAN DIEGO, CA 92122 | DELTA DENTAL OF ARIZONA | $757 | $0 | $757 | 1.95% |
| MARSH & MCLENNAN AGENCY LLC | 7202 E ROSEWOOD ST STE 200 TUCSON, AZ 85710 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $0 | $4K | 14.71% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.88% |
| MARSH & MCLENNAN AGENCY LLC | 7202 E ROSEWOOD ST STE 200 TUCSON, AZ 85710 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $0 | $4K | 14.79% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.92% |
| MARSH & MCLENNAN AGENCY LLC | 7202 E ROSEWOOD ST STE 200 TUCSON, AZ 85710 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 14.22% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.69% |
| MARSH & MCLENNAN AGENCY LLC | 7202 E ROSEWOOD ST STE 200 TUCSON, AZ 85710 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $854 | $0 | $854 | 22.08% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $342 | $342 | 8.84% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT & TOUCHE | 7202 E. ROSEWOOD STE 200 TUCSON, AZ 85710 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $84 | $34 | $118 | 8.03% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT & TOUCHE | PO BOX 741259 LOS ANGELES, CA 90074 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $63 | $0 | $63 | 4.29% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: J SMITH LANIER & CO | 11330 LAKEFIELD DRIVE SUITE 100, BLDG 1 JOHNS CREEK, GA 30097 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $0 | $14 | $14 | 0.95% |
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 | 302 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 196 | $322K |
| Dental | DELTA DENTAL OF ARIZONA | 104 | $39K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 181 | $117K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 181 | $117K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 181 | $117K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 181 | $117K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 181 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.