| 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 | $201K | $46K | $247K | 6.73% |
| HAYS COMPANIES, INC.3 | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF ARIZONA | $29K | — | $29K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS. W. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 6.96% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 400 571 MONON BLVD. CARMEL, IN 46032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21K | $6K | $26K | 19.52% |
| ASSUREX3 | SUITE 800 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 3.61% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS. W. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | THE PAUL REVERE LIFE INSURANCE COMPANY | $9K | $1K | $10K | 7.92% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 400 571 MONON BLVD. CARMEL, IN 46032 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $1K | $11K | 11.25% |
| HAYS COMPANIES, INC.3 | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF ARIZONA | $5K | — | $5K | 6.55% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | SUITE 400 571 MONON BLVD. CARMEL, IN 46032 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $3K | $12K | 21.84% |
| ASSUREX3 | SUITE 800 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS. W. | 16220 N. SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 6.54% |
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 | 881 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 892 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KEPRO | 881 | $37K |
| Dental | DELTA DENTAL OF ARIZONA | 1,399 | $576K |
| Vision | DELTA DENTAL OF ARIZONA | 997 | $74K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,605 | $3.7M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 267 | $97K |
| Long-term disability(7 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,605 | $4.2M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,605 | $3.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,605 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.