| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | BLUE CROSS BLUE SHIELD OF ARIZONA | $39K | — | $39K | 3.65% |
| ROBERT J KADZIELAWSKI3 Filed as: ROBERT J KADZIEFLAWSKI | 4411 NORTH 19TH AVENUE PHOENIX, AZ 85015 | TRANSAMERICA LIFE INSURANCE COMPANY | $13K | — | $13K | 10.36% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 E DOUBLETREE RANCH ROAD STE C-103 SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $5K | — | $5K | 4.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD STE 600 GLENDALE, CA 912033944 | TRANSAMERICA LIFE INSURANCE COMPANY | $187 | — | $187 | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 369 S. ARIZONA AVE SUITE A CHANDLER, AZ 85225 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $41 | $8K | 6.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 1.15% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS LLC | 9370 SKY PARK CT STE 250 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | — | $10K | 36.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 369 ARIZONA AVE STE A CHANDLER, AZ 85225 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $41 | $8K | 27.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $114 | $114 | 0.42% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS LLC | 9370 SKY PARK CT STE 250 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 36.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 369 S. ARIZONA AVE SUITE A CHANDLER, AZ 85225 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $41 | $6K | 27.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $103 | $103 | 0.49% |
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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 95 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 218 | $117K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 218 | $117K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 218 | $117K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 95 | $1.1M |
| Other(4 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 218 | $295K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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.
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.