| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF AZ INC NATIONAL ACCOUNTIN | 26 CENTRUY BLVD. NASHVILLE, TN 37214 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $30K | — | $30K | 5.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA, IN | P.O. BOX 101162 PASADENA, CA 911890001 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 3.29% |
| AXA ASSISTANCE, USA Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $145 | $145 | 0.03% |
| CSA GENERAL INSURANCE AGENCY3 Filed as: CSA GENERAL INSURANCE AGENCY, INC. | 2480 W. LAS PALMARITAS PHOENIX, AZ 85021 | THE FIDELITY SECURITY LIFE INSURANCE COMPANY - EYEMED VISION CARE | $5K | — | $5K | 6.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | P.O. BOX 101162 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | — | $965 | $965 | — |
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 | 1,413 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 463 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 6 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,894 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF ARIZONA, INC. | 1,894 | $23.7M |
| Dental | BLUE CROSS & BLUE SHIELD OF ARIZONA, INC. | 1,894 | $23.7M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS & BLUE SHIELD OF ARIZONA, INC. | 1,894 | $23.8M |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,515 | $515K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,894 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.