| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95148 CHICAGO, IL 60694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $37K | $37K | 3.41% |
| STRONG TOWER INSURANCE GROUP, INC.3 | 3325 EAST BASELINE ROAD GILBERT, AZ 85234 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $20K | $20K | 1.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8800 EAST RAINTREE DRIVE, SUITE 250 SCOTTSDALE, AZ 85260 | BLUE CROSS BLUE SHIELD OF ARIZONA | $6K | $0 | $6K | 7.37% |
| STRONG TOWER INSURANCE GROUP, INC.3 | 3325 EAST BASELINE ROAD GILBERT, AZ 85234 | BLUE CROSS BLUE SHIELD OF ARIZONA | $2K | $0 | $2K | 2.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $0 | $7K | 10.66% |
| STRONG TOWER INSURANCE GROUP, INC.3 | 3325 EAST BASELINE ROAD GILBERT, AZ 85234 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.34% |
| SYNERGY ENROLLMENT & BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS, LLC | PO BOX 210234 CHULA VISTA, CA 91921 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 669 RIVER DRIVE CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $988 | $988 | 1.45% |
| SYNERGY ENROLLMENT & BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS, LLC | 9370 SKY PARK COURT, SUITE 250 SAN DIEGO, CA 92123 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | $0 | $7K | 12.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $387 | $3K | 5.79% |
| STRONG TOWER INSURANCE GROUP, INC.3 | 3325 EAST BASELINE ROAD GILBERT, AZ 85234 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 2.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 WEST 4TH STREET, SUITE 1300 CINCINNATI, OH 45202 | AVESIS INSURANCE INCORPORATED | $841 | $0 | $841 | 5.96% |
| STRONG TOWER INSURANCE GROUP, INC.3 | 3325 EAST BASELINE ROAD GILBERT, AZ 85234 | AVESIS INSURANCE INCORPORATED | $456 | $0 | $456 | 3.23% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST VEVA 16, SUITE 320 BLUE BELL, PA 19422 | AVESIS INSURANCE INCORPORATED | $228 | $0 | $228 | 1.62% |
| SYNERGY ENROLLMENT & BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS, LLC | PO BOX 210234 CHULA VISTA, CA 91921 | TRUSTMARK INSURANCE COMPANY | $2K | $0 | $2K | 16.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1345 EAST CHANDLER BOULEVARD BUILDING 1, SUITE 103 PHOENIX, AZ 85048 | TRUSTMARK INSURANCE COMPANY | $2K | $0 | $2K | 12.20% |
| ROBERT J KADZIELAWSKI3 | 5746 WEST MONONA DRIVE GLENDALE, AZ 85308 | TRANSAMERICA LIFE INSURANCE COMPANY | $560 | $0 | $560 | 8.88% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 EAST DOUBLETREE RANCH ROAD SUITE C-103 SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $221 | $0 | $221 | 3.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | TRANSAMERICA LIFE INSURANCE COMPANY | $70 | $0 | $70 | 1.11% |
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 | 126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 161 | $1.1M |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 231 | $84K |
| Vision | AVESIS INSURANCE INCORPORATED | 231 | $14K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 128 | $82K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 128 | $68K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 161 | $1.1M |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 128 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.