| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAROL JEAN HALL3 | 5737 E CHAPTER DRIVE TUCSON, AZ 85708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $106 | $3K | 6.04% |
| R AND T FIGUEROA LLC3 Filed as: R & T FIGUEROA | 7569 S CARLISLE AVE TUCSON, AZ 85746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $27 | $1K | 2.84% |
| 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 | $792 | — | $792 | 1.88% |
| CAROL VAN3 | 3120 WINDJAMMER DR COLORADO SPRINGS, CO 80920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $386 | — | $386 | 0.92% |
| MARQUEZ BENEFIT GROUP LLC3 | 11225 NORTH 28TH DR PHOENIX, AZ 85029 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $144 | $135 | $279 | 0.66% |
| EC BENEFITS INC3 | 8038 S 38TH PLACE PHOENIX, AL 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $220 | — | $220 | 0.52% |
| PAUL BYNUM3 | PO BOX 12306 TUCSON, AZ 85732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $161 | — | $161 | 0.38% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $114 | $21 | $135 | 0.32% |
| JOSEPH QUINTANA3 | 27 N COUNTRY CLUB DR PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 0.09% |
| BST COMPANIES INC3 | 425 S FREMONT AV TUCSON, AZ 85719 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 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 | 4.84% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | EMPLOYERS DENTAL SERVICES | $125 | — | $125 | 7.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $157K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $16K |
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 |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 171 | $249K |
| Dental | EMPLOYERS DENTAL SERVICES | 13 | $2K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 190 | $277K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 34 | $42K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 171 | $249K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 171 | $249K |
| 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."
No prospect flags tripped on this filing.