| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS ALLEN GIBSON3 | 16837 S 18TH WAY PHOENIX, AZ 85048 | BLUE CROSS BLUE SHIELD OF ARIZONA | $54K | $0 | $54K | 15.02% |
| JEFFERY GRIFFIN3 | 6720 N. SCOTTSDALE RD SUITE 310 SCOTTSDALE, AZ 85253 | BLUE CROSS BLUE SHIELD OF ARIZONA | -$6K | $0 | -$6K | -1.75% |
| THOMAS ALLEN GIBSON3 | 16837 S 18TH WAY PHOENIX, AZ 85048 | STARMOUNT LIFE INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| THOMAS ALLEN GIBSON3 | 16837 S 18TH WAY PHOENIX, AZ 85048 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 2.68% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF ARIZONA | 8220 NORTH 23RD AVENUE BLDG 2 PHOENIX, AZ 85021 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 8.49% |
| JEFFERY GRIFFIN3 | 6720 N. SCOTTSDALE RD SUITE 310 SCOTTSDALE, AZ 85253 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | -$15 | $0 | -$15 | -0.08% |
| THOMAS ALLEN GIBSON3 | 16837 S 18TH WAY PHOENIX, AZ 85048 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | -$25 | $0 | -$25 | -0.13% |
| THOMAS ALLEN GIBSON3 | 16837 S 18TH WAY PHOENIX, AZ 85048 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | 8220 NORTH 23RD AVE PHOENIX, AZ 85021 | $135K |
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 | 281 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 185 | $362K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 196 | $67K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 253 | $378K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 281 | $20K |
| Short-term disability | STANDARD INSURANCE COMPANY | 117 | $46K |
| Long-term disability | STANDARD INSURANCE COMPANY | 117 | $46K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 185 | $362K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 185 | $362K |
| Other | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 281 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 281 | — |
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.