| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MAIN ST EXEC & EMPLOYEE BENEFITS3 Filed as: MAIN ST EXEC & EMPLOYEE BENEF LLC | 7440 N ORACLE RD BLDG 5 TUCSON, AZ 85704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | — | $18K | 10.00% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF ARIZONA, LLC | 1760 E RIVER RD STE 300 TUCSON, AZ 857185956 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $4K | $8K | 5.23% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $699 | $39 | $738 | 0.49% |
| MAIN ST EXEC & EMPLOYEE BENEFITS3 Filed as: MAIN ST EXEC & EMPLOYEE BENEF LLC | 7440 N ORACLE RD BLDG 5 TUCSON, AZ 85704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | — | $14K | 15.00% |
| MAIN ST EXEC & EMPLOYEE BENEFITS3 Filed as: MAIN ST EXEC & EMPLOYEE BENEF LLC | 7440 N ORACLE RD BLDG 5 TUCSON, AZ 85704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | — | $10K | 17.00% |
| MAIN ST EXEC & EMPLOYEE BENEFITS3 Filed as: MAIN ST EXEC & EMPLOYEE BENEF LLC | 7440 N ORACLE RD BLDG 5 TUCSON, AZ 85704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 17.00% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF ARIZONA, LLC | 1760 E RIVER RD STE 300 TUCSON, AZ 857185956 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $979 | $8K | 20.67% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $39 | $3K | 6.46% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF ARIZONA, LLC | 1760 E RIVER RD STE 300 TUCSON, AZ 857185956 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $693 | $5K | 20.70% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $39 | $2K | 6.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JORGENSEN HEALTHCARE ASSOCIATES INC EIN 86-0687859 EAP PROVIDER | Other services Service code 49 | — | $9K |
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 | 591 | 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) | 591 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | METROPOLITAN LIFE INSURANCE COMPANY | 350 | $26K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 530 | $152K |
| Vision(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 530 | $178K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 590 | $108K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $91K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 591 | $176K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 590 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 591 | — |
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.