| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAROL JEAN HALL3 | PO BOX 15158 TUCSON, AZ 85708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $156 | $5K | 10.88% |
| R AND T FIGUEROA LLC3 Filed as: R & T FIGUEROA | 7569 S CARLISLE AVE TUCSON, AZ 85746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $258 | $2K | 4.94% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH STREET KANSAS CITY, MO 64112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $79 | $2K | 3.64% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $490 | $112 | $602 | 1.37% |
| CAROL VAN3 | 3120 WINDJAMMER DR COLORADO SPRINGS, CO 80920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $451 | — | $451 | 1.02% |
| EC BENEFITS INC3 | 8038 S 38TH PLACE PHOENIX, AL 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $305 | — | $305 | 0.69% |
| JOSEPH QUINTANA3 | 27 N COUNTRY CLUB DR PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.12% |
| BST COMPANIES INC3 Filed as: BST COMPANIES | 481 E DOWNTOWN ST TUCSON, AZ 85701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| REYNALDO R GRAJEDA3 | 4915 CAMINO DE MONTE NE ALBUQUERQUE, NM 87111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $1K | — | $1K | 4.97% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | EMPLOYERS DENTAL SERVICES | $119 | — | $119 | 7.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $146K |
| CBIZ BENEFITS AND INS SERVICES INC EIN 31-1582098 BROKER | Other commissions Service code 55 | — | $51K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $19K |
| CBIZ BENEFITS AND INS SERVICES | Other commissions Service code 55 | — | $8K |
| WORKERS ASSISTANCE PROGRAM, INC. EIN 74-1847991 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $4K |
| AMERICAN SPECIALTY HEALTH SYSTEMS EIN 33-0938349 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $0 |
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 | 190 | 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) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EMPLOYERS DENTAL SERVICES | 11 | $2K |
| Vision | VISION SERVICE PLAN | 190 | $26K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 39 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.