| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | SELECTHEALTH | $49K | — | $49K | 3.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $49K | $6K | $55K | 5.23% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | SUITE 100 9225 PRIORITY WAY DR W INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $46K | $4K | $50K | 4.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS CORROON CORP. OF AZ | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | DELTA DENTAL OF ARIZONA | $25K | — | $25K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $37K | $8K | $45K | 16.88% |
| M J INSURANCE INC.3 Filed as: M-J INSURANCE INC | PO BOX 50435 INDIANAPOLIS, IN 46250 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $497 | $213 | $710 | 0.27% |
| ASSUREX3 | SUITE 800 175 S. THIRD ST COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $298 | $298 | $596 | 0.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | THE PAUL REVERE LIFE INSURANCE COMPANY | $17K | $5K | $23K | 9.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $599 | $8K | 9.09% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | SUITE 100 9225 PRIORITY WAY DR W INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $283 | $5K | 5.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $5K | $17K | 23.42% |
| ASSUREX3 | SUITE 800 175 S. THIRD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $122 | $122 | $244 | 0.34% |
| M J INSURANCE INC.3 Filed as: M-J INSURANCE INC | PO BOX 50435 INDIANAPOLIS, ID 46250 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $204 | — | $204 | 0.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
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 | 902 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 910 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ARIZONA | 0 | $496K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 736 | $60K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,677 | $1.1M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 202 | $86K |
| Long-term disability(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,677 | $1.6M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 11,280 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,280 | — |
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.