| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH STREET STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | — | $16K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH STREET STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | — | $18K | 19.30% |
| FMLA SOURCE INC5 | 455 N CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8K | $8K | 9.11% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH STREET STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 5.22% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $2K | — | $2K | 3.68% |
| R AND T FIGUEROA LLC3 | 7569 S CARLISLE AVE TUCSON, AZ 85746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $160 | $3K | 7.47% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3101 N CENTRAL SUITE 300 PHOENIX, AZ 85012 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.74% |
| BST COMPANIES INC3 | 319 N CAMERON VIEW PLACE TUCSON, AZ 85745 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $714 | $17 | $731 | 2.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | 16220 N SCOTTSDALE RD SCOTTSDALE, AZ 85254 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $561 | — | $561 | 1.61% |
| MARQUEZ BENEFIT GROUP LLC3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $239 | $232 | $471 | 1.35% |
| ANNALISA MARIE KURZ3 | 8602 N BLACK CANYON HWY PHOENIX, AZ 85201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $172 | $124 | $296 | 0.85% |
| CAROL JEAN HALL3 | 5737 E CHAPTER DR TUCSON, AZ 85708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $197 | $3 | $200 | 0.57% |
| EC BENEFITS INC3 | 8308 S 38TH PL PHOENIX, AZ 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.13% |
| PAUL A BYNUM3 | PO BOX 12306 TUCSON, AZ 85732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.06% |
| ENRIQUE GONZALEZ3 | 1541 N PLACITA COLONIA DE ORO TUCSON, AZ 85745 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.05% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD PHOEIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.05% |
| SHAWN JEFFERY WARREN3 | 6950 WEST ROWEL STREET PEORIA, AZ 85383 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.05% |
| DEBORAH ANN BERRY3 | 1042 E 9TH PLACE MESA, AZ 85203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.04% |
| STEVEN ROBERT KURZ3 | 8611 N BLACK CANYON HWY PEORIA, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $3 | $12 | 0.03% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| JAMES D THRESHER3 | PO BOX 19569 HAPPY JACK, AZ 86024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH STREET STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 19.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $335K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $18K |
| CBIZ BENEFITS & INSURANCE SERVICES BROKER | Insurance agents and brokers Service code 22 | PO BOX 632886 CINCINNATI, OH 45263 | $0 |
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 | 507 | 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) | 507 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 373 | $50K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 507 | $125K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $110K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 451 | $56K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 507 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 507 | — |
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.