| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | BLUE CROSS BLUE SHIELD OF ARIZONA | $29K | — | $29K | 4.96% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | 700 W 47TH STREET KANSAS CITY, MO 64112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $94 | $5K | 19.03% |
| KURZ & VALDEZ BENEFIT ENROLLMENT SO3 | 14640 N 90TH DR PEORIA, AZ 85381 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $3K | $5K | 18.79% |
| JB & H LLC3 | 8707 E SAGUARO VIEW PL VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 14.61% |
| PAUL BYNUM3 | PO BOX 12306 TUCSON, AZ 85746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 5.19% |
| LORENZA TORRES3 | 9636 E PASEO SAN BERNARDO DR TUCSON, AZ 85747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $22 | $1K | 4.21% |
| R AND T FIGUEROA LLC3 Filed as: R & T FIGUEROA | 7569 S CARLISLE AVE TUCSON, AZ 85746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $546 | $22 | $568 | 2.14% |
| CAROL JEAN HALL3 | 5737 E CHAPTER DRIVE TUCSON, AZ 85708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $356 | $11 | $367 | 1.38% |
| COLTON WILLIAM GARRETT3 | 16884 W MARSHALL LN SURPRISE, AZ 85388 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $262 | $9 | $271 | 1.02% |
| LUCILLE KEHAUNANI YBARRA3 | 5636 W COOLIDGE ST PHOENIX, AZ 85031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $189 | — | $189 | 0.71% |
| DARREL GENE DUFFORD3 | 6034 E LONG SHADOW TRL SCOTTSDALE, AZ 85266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $35 | $49 | 0.18% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 14.39% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $652 | — | $652 | 10.31% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $606 | — | $606 | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | EMPLOYERS DENTAL SERVICE | $321 | — | $321 | 5.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WORKERS ASSISTANCE PROGRAM, INC. EIN 74-1847991 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $8K |
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 | 137 | 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) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 80 | $586K |
| Dental(2 contracts, 2 carriers) | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 71 | $24K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 85 | $6K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $6K |
| Long-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 137 | $44K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 80 | $586K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.