| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | STE 400 571 MONON BLVD. CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $114K | $15K | $128K | 6.59% |
| 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 | $16K | — | $16K | 2.88% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF ARIZONA | $12K | — | $12K | 2.13% |
| 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 | $17K | — | $17K | 9.29% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | SUITE 400 571 MONON BLVD. CARMEL, IN 46032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLISTOWERSWATSON | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | THE PAUL REVERE LIFE INSURANCE COMPANY | $12K | $2K | $14K | 9.01% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 400 571 MONON BLVD. CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $672 | $10K | 10.75% |
| 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 | 6.24% |
| HAYS COMPANIES, INC.3 | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 3.74% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 400 571 MONON BLVD. CARMEL, IN 46032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $3K | $15K | 21.47% |
| ASSUREX3 | SUITE 800 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $3K | $3K | 3.64% |
| 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 | $5K | — | $5K | 9.64% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC | SUITE 400 571 MONON BLVD. CARMEL, IN 46032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.50% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 400 571 MONON BLVD. CARMEL, IN 46032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $3K | $5K | 25.00% |
| ASSUREX3 | SUITE 800 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $1K | $1K | 6.44% |
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 | 943 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 950 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KEPRO | 896 | $38K |
| Dental | DELTA DENTAL OF ARIZONA | 358 | $568K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 856 | $74K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,734 | $1.9M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 240 | $90K |
| Long-term disability(7 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,734 | $2.4M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,734 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,734 | — |
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.