| 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 | $54K | — | $54K | 3.99% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | SUITE 225 3900 E CAMELBACK ROAD PHOENIX, AZ 85018 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $65K | $12K | $77K | 8.37% |
| 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 | $27K | — | $27K | 5.00% |
| 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 | $15K | $7K | $22K | 7.32% |
| 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 | $22K | $5K | $28K | 13.74% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | PO BOX 50435 INDIANAPOLIS, IN 46250 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.57% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | SUITE 225 3900 E CAMELBACK ROAD PHOENIX, AZ 85018 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $241 | $241 | 0.12% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | SUITE 225 3900 E CAMELBACK ROAD PHOENIX, AZ 85018 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $924 | $9K | 11.21% |
| 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 | $8K | $1K | $9K | 13.28% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | SUITE 225 3900 E CAMELBACK ROAD PHOENIX, AL 85018 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 1.87% |
| ASSUREX3 | SUITE 800 175 S. THIRD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $112 | $112 | $224 | 0.33% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | SUITE 100 9225 PRIORITY WAY WEST DRIVE INDIANAPOLIS, IN 46240 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $201 | $201 | 0.30% |
| 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 | $5K | — | $5K | 9.98% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 225 3900 E. CAMELBACK ROAD PHOENIX, AZ 85018 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 24.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 100 9225 PRIORITY WAY WEST DRIVE INDIANAPOLIS, IN 46240 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $4K | $4K | 12.91% |
| ASSUREX3 | SUITE 800 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 11.01% |
| GOODRICH, BARRY, SCOTT3 | PO BOX 50435 INDIANAPOLIS, IN 46250 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.13% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 225 3900 E. CAMELBACK ROAD PHOENIX, AZ 85018 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 24.33% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 100 9225 PRIORITY WAY WEST DRIVE INDIANAPOLIS, IN 46240 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $1K | $1K | 14.67% |
| ASSUREX3 | SUITE 800 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $928 | — | $928 | 11.24% |
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 | 857 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 862 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ARIZONA | 587 | $541K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 727 | $54K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,174 | $920K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 199 | $77K |
| Long-term disability(7 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,174 | $1.5M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,174 | $956K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,174 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.