| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 641122050 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $61K | $61K | 5.48% |
| JULIE KICKER3 | 719 E COTTONWOOD LANE CASA GRANDE, AZ 85122 | AFLAC | $3K | $170 | $3K | 4.38% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $2K | — | $2K | 2.37% |
| JOHN DOLLAR3 Filed as: JOHN R DOLLAR | 588 EAST WOLF HOLLOW DRIVE CASA GRANDE, AZ 85122 | AFLAC | $1K | $151 | $1K | 1.82% |
| SANDRA L SARFF3 Filed as: SANDRA SARFF | 7090 N ORACLE ROAD 178 PMB 152 TUCSON, AZ 85704 | AFLAC | $969 | — | $969 | 1.28% |
| ZAKERY ALLEN HARLOW3 | 3755 N BUSINESS CENTER DRIVE SUITE 140 TUCSON, AZ 85705 | AFLAC | $660 | $64 | $724 | 0.96% |
| MICHAEL FATHERREE3 | 11876 MOORHEN CIR FORT WORTH, TX 76244 | AFLAC | $708 | $4 | $712 | 0.94% |
| LAUREL L HARLOW3 | 4566 NORTH FIRST AVE SUITE 140 TUCSON, AZ 85718 | AFLAC | $368 | $60 | $428 | 0.57% |
| TULA BOYLES3 Filed as: TULA G BOYLES | 1134 W SHOAL CREEK LANE ORO VALLEY, AZ 85737 | AFLAC | $379 | — | $379 | 0.50% |
| SCOTT WEBB3 | 2355 W PINNACLE PEAK ROAD SUITE 380 PHOENIX, AZ 85027 | AFLAC | $271 | $60 | $331 | 0.44% |
| MARK HILL3 | 7673 N SUMMIT PASS SUITE 214 PRESCOTT VALLEY, AZ 86315 | AFLAC | $287 | — | $287 | 0.38% |
| MARSHA L ECHOLS3 Filed as: MARSHA ECHOLS | PO BOX 594 THATCHER, AZ 85552 | AFLAC | $251 | — | $251 | 0.33% |
| JAMES HUNT3 | 15010 N 61ST PLACE SCOTTSDALE, AZ 85254 | AFLAC | $250 | — | $250 | 0.33% |
| BENEFIT INTELLIGENCE INC3 Filed as: BENEFIT INTELLIGENCE-GMI INC | 4862 E BASELINE ROAD SUITE 101 MESA, AZ 85206 | AFLAC | $248 | — | $248 | 0.33% |
| HEALTHCARE NETWORKS OF AMERICA3 | 6127 S RAINBOW BLVD SUITE 100 LAS VEGAS, NV 89118 | AFLAC | $194 | — | $194 | 0.26% |
| JACOB C ECHOLS3 | 3850 EAST BASELINE ROAD SUITE 116 MESA, AZ 85206 | AFLAC | $165 | — | $165 | 0.22% |
| NANCY L SIGL3 | 21 YARROW LANE NOVATO, CA 94948 | AFLAC | $160 | — | $160 | 0.21% |
| DONALD GREEN3 Filed as: DONALD A GREEN | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $107 | — | $107 | 0.14% |
| CHERYL WILLS3 | 12801 ROSECRANS AVE APT 134 NORWALK, CA 90650 | AFLAC | $86 | — | $86 | 0.11% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LANE PHOENIX, AZ 85042 | AFLAC | $80 | — | $80 | 0.11% |
| PREFERRED MARKETING CORP3 | 7402 KINGS RIVER CT HUMBLE, TX 77346 | AFLAC | $73 | — | $73 | 0.10% |
| BRENDA S O BERRY3 | PO BOX 686 THATCHER, AZ 85552 | AFLAC | $70 | — | $70 | 0.09% |
| J M ELLWOOD3 | 8220 E SAN MIGUEL AVE SCOTTSDALE, AZ 85250 | AFLAC | $56 | — | $56 | 0.07% |
| ZACHARY HARTMAN3 Filed as: ZACHARY K HARTMAN | 13820 SOUTH 44TH STREET APT 1190 PHOENIX, AZ 85044 | AFLAC | $35 | — | $35 | 0.05% |
| LEO SUPAK3 Filed as: LEO D SUPAK | 11800 WILSHIRE AVE NE ALBUQUERQUE, NM 87122 | AFLAC | $27 | — | $27 | 0.04% |
| VIRGINIA DIANE HALL3 | 5500 W LAKE RIVER LANE BOISE, ID 83703 | AFLAC | $20 | — | $20 | 0.03% |
| VIRGINIA RUTH HUNT3 | 15010 N 61ST PLACE SCOTTSDALE, AZ 85254 | AFLAC | $11 | — | $11 | 0.01% |
| V LAMAR ECHOLS3 | 3723 E WASHINGTON COURT GILBERT, AZ 85234 | AFLAC | $1 | — | $1 | 0.00% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC OF ARIZONA | 2555 E CAMELBACK ROAD SUITE 700 PHOENIX, AZ 85016 | AFLAC | $1 | — | $1 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF ARIZONA | $3K | — | $3K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.22% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 20.11% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $1K | — | $1K | 5.47% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $460 | $1K | 14.54% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNITED DENTAL CARE OF ARIZONA INC | $331 | $108 | $439 | 9.27% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 1765 E SKYLINE DRIVE TUCSON, AZ 85718 | JORGENSEN HEALTHCARE ASSOCIATES, INC. DBA JORGENSEN BROOKS GROUP | $465 | $5K | $5K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE CO EIN 47-0322111 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $3K |
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 | 149 | 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) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 103 | $1.1M |
| Dental(3 contracts, 3 carriers) | AFLAC | 77 | $142K |
| Vision | VISION SERVICE PLAN | 75 | $20K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $41K |
| Short-term disability | AFLAC | 77 | $75K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 43 | $29K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 187 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.