| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 Filed as: EMPLOYEE BENEFITS INTL AZ | 7901 NORTH 16TH STREET, SUITE 200 PHOENIX, AZ 85020 | BANNER HEALTH AND AETNA HEALTH | $0 | $63K | $63K | 5.23% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 Filed as: EMPLOYEE BENEFITS INTL AZ | 7901 NORTH 16TH STREET, SUITE 200 PHOENIX, AZ 85020 | AETNA LIFE INSURANCE COMPANY | $12K | $1K | $13K | 10.99% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 Filed as: EMPLOYEE BENEFITS INTL AZ | 2525 EAST ARIZONA BILTMORE CIRCLE SUITE D1 PHOENIX, AZ 85016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $4K | $16K | 14.09% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TEXAS HIGHWAY S BUILDING 2, SUITE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.25% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 Filed as: EMPLOYEE BENEFITS INTL AZ | 7901 NORTH 16TH STREET, SUITE 200 PHOENIX, AZ 85020 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $1K | $0 | $1K | 10.04% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH STREET HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $653 | $0 | $653 | 14.83% |
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 | 163 | 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) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BANNER HEALTH AND AETNA HEALTH | 311 | $1.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 311 | $116K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 260 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $111K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $111K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $111K |
| Prescription drug(2 contracts, 2 carriers) | BANNER HEALTH AND AETNA HEALTH | 311 | $1.3M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 179 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.