| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF ARIZONA | $3K | — | $3K | 4.88% |
| JULIE KICKER3 | 719 E COTTONWOOD LANE CASA GRANDE, AZ 85122 | AFLAC | $2K | $279 | $3K | 4.90% |
| MICHAEL FATHERREE3 | 171 COUNTRY ROAD 1559 ALBA, TX 75410 | AFLAC | $467 | $55 | $522 | 0.97% |
| SANDRA L SARFF3 Filed as: SANDRA SARFF | 7090 N ORACLE RD 178 PMB 152 TUCSON, AZ 85704 | AFLAC | $494 | — | $494 | 0.92% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $418 | — | $418 | 0.78% |
| ZACHERY HARLOW3 | 3204 N ACADEMY BLVD SUITE 130 COLORADO SPRINGS, CO 80917 | AFLAC | $237 | $56 | $293 | 0.55% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | 160 W SANTA CLARA ST SUITE 450 SAN JOSE, CA 95113 | AFLAC | $269 | — | $269 | 0.50% |
| JOHN DOLLAR3 | 588 E WOLF HOLLOW DR CASA GRANDE, AZ 85122 | AFLAC | $208 | — | $208 | 0.39% |
| JASON ELIJAH ANGEL3 Filed as: JASON ANGEL | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $182 | — | $182 | 0.34% |
| MARSHA L ECHOLS3 Filed as: MARSHA ECHOLS | PO BOX 594 THATCHER, AZ 85552 | AFLAC | $172 | — | $172 | 0.32% |
| JAMES HUNT3 | 15010 N 61ST PLACE SCOTTSDALE, AZ 85254 | AFLAC | $168 | — | $168 | 0.31% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $138 | — | $138 | 0.26% |
| MARK HILL3 | PO BOX 85715 TUCSON, AZ 85754 | AFLAC | $134 | — | $134 | 0.25% |
| JACOB C ECHOLS3 Filed as: JACOB ECHOLS | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $132 | — | $132 | 0.25% |
| TULA BOYLES3 | 5227 N FAIRWAY HEIGHTS DR TUCSON, AZ 85749 | AFLAC | $116 | — | $116 | 0.22% |
| SCOTT WEBB3 | 2155 W PINNACLE PEAK RD SUITE 205 PHOENIX, AZ 85027 | AFLAC | $106 | — | $106 | 0.20% |
| NANCY L SIGL3 Filed as: NANCY SIGL | 21 YARROW LANE NOVATO, CA 94947 | AFLAC | $91 | — | $91 | 0.17% |
| BENEFIT INTELLIGENCE INC3 Filed as: BENEFIT INTELLIGENCE GMI- INC | 4862 E BASELINE RD SUITE 101 MESA, AZ 85206 | AFLAC | $88 | — | $88 | 0.16% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 10000 N 31ST AVE SUITE C107 PHOENIX, AZ 85051 | AFLAC | $81 | — | $81 | 0.15% |
| CHERYL WILLS3 | 12801 ROSECRANS AVE APT 134 NORWALK, CA 90650 | AFLAC | $70 | — | $70 | 0.13% |
| BENEFIT INTELLIGENCE INC3 Filed as: BENEFIT INTELLIGENCE INC. | 4862 E BASELINE RD SUITE 101 MESA, AZ 85206 | AFLAC | $67 | — | $67 | 0.12% |
| TULA BOYLES3 | 1134 W SHOAL CREEK LANE ORO VALLEY, AZ 85737 | AFLAC | $66 | — | $66 | 0.12% |
| LAUREL L HARLOW3 Filed as: LAUREL HARLOW | 6200 W ROAN PLACE TUCSON, AZ 85743 | AFLAC | $65 | — | $65 | 0.12% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $63 | — | $63 | 0.12% |
| ZAKERY HARLOW3 | 3755 N BUSINESS CENTER DR TUCSON, AZ 85705 | AFLAC | $49 | — | $49 | 0.09% |
| PREFERRED MARKETING CORP3 | 1194 E LAKEVIEW DR. SAN TAN VALLEY, AZ 85143 | AFLAC | $48 | — | $48 | 0.09% |
| J M ELLWOOD3 | 8220 S SAN MIGUEL AVE SCOTTSDALE, AZ 85250 | AFLAC | $45 | — | $45 | 0.08% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LANE PHOENIX, AZ 85042 | AFLAC | $43 | — | $43 | 0.08% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 29622 N 21ST DR PHOENIX, AZ 85085 | AFLAC | $42 | — | $42 | 0.08% |
| BRENDA S O BERRY3 Filed as: BRENDA BERRY | PO BOX 686 THATCHER, AZ 85552 | AFLAC | $41 | — | $41 | 0.08% |
| LAUREL L HARLOW3 Filed as: LAUREL HARLOW | 3755 N BUSINESS CENTER DR SUITE 4 TUCSON, AZ 85705 | AFLAC | $34 | — | $34 | 0.06% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 360 W HUBBARD ST APT 1105 CHICAGO, IL 60654 | AFLAC | $28 | — | $28 | 0.05% |
| KIMBERLY RODRIGUEZ3 | 37057 S GAMBEL QUAIL DR MARANA, AZ 85658 | AFLAC | $23 | — | $23 | 0.04% |
| ZACHARY HARTMAN3 | 13820 SOUTH 44TH ST APT 1190 PHOENIX, AZ 85044 | AFLAC | $23 | — | $23 | 0.04% |
| MARK K HASLEY3 Filed as: MARK HASLEY | 21925 N 70TH AVE GLENDALE, AZ 85310 | AFLAC | $16 | — | $16 | 0.03% |
| SHARON MCKELVEY3 | 197 N NOTTINGHAM LANE LOT 3 PAYSON, AZ 85541 | AFLAC | $16 | — | $16 | 0.03% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $15 | — | $15 | 0.03% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 3420 E SHEA BLVD SUITE 168 PHOENIX, AZ 85028 | AFLAC | $14 | — | $14 | 0.03% |
| HEALTHCARE NETWORKS OF AMERICA3 | 6127 S RAINBOW BLVD SUITE 100 LAS VEGAS, NV 89118 | AFLAC | $12 | — | $12 | 0.02% |
| SHAWN HOLTORF3 | 5522 W NORTHWOOD DR GLENDALE, AZ 85310 | AFLAC | $12 | — | $12 | 0.02% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $11 | — | $11 | 0.02% |
| NATALIE MALHAM3 | 3850 E BASELINE RD SUITE 116 MESA, AK 85206 | AFLAC | $11 | — | $11 | 0.02% |
| TREVOR NORENBERG3 | 10000 N 31ST AVE PHOENIX, AZ 85051 | AFLAC | $11 | — | $11 | 0.02% |
| VIRGINIA RUTH HUNT3 | 15010 N 61ST PLACE SCOTTSDALE, AZ 85254 | AFLAC | $9 | — | $9 | 0.02% |
| VIRGINIA DIANE HALL3 | 5500 W LAKE RIVER LANE BOISE, ID 83703 | AFLAC | $9 | — | $9 | 0.02% |
| JEFFREY S GIBSON3 Filed as: JEFFREY GIBSON | 4805 LAKE BROOK DR. SUITE 220 GLEN ALLEN, VA 23060 | AFLAC | $9 | — | $9 | 0.02% |
| JOHN BURLEY3 | 3060 W CALLE LUCINDA TUCSON, AZ 85741 | AFLAC | $3 | — | $3 | 0.01% |
| JULIA ANN COAST3 Filed as: JULIA COAST | 1409 E MALIBU DR TEMPE, AK 85282 | AFLAC | $3 | — | $3 | 0.01% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNOUGHTON | 1308 NATURE WALK BLVD SW HUNTSVILLE, AL 35824 | AFLAC | $2 | — | $2 | 0.00% |
| LINDA J DOSS3 Filed as: LINDA DOSS | 6556 S VAN BUREN AVE TUCSON, AZ 85756 | AFLAC | $1 | — | $1 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 18.41% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $879 | $5K | 18.53% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENIFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $1K | — | $1K | 5.49% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $367 | $2K | 12.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $896 | $295 | $1K | 13.30% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED DENTAL CARE OF ARIZONA | $145 | — | $145 | 6.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CBIZ BENEFITS AND INS SERVICES INC EIN 31-1582098 BROKER | Other commissions Service code 55 | — | $45K |
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $8K |
| JORGENSEN HEALTHCARE ASSOC INC EIN 86-0687859 EAP PROVIDER | Other services Service code 49 | — | $6K |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 3 carriers) | DELTA DENTAL OF ARIZONA | 62 | $123K |
| Vision | VISION SERVICE PLAN | 68 | $20K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $38K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 58 | $67K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 39 | $25K |
| Other(3 contracts, 2 carriers) | AFLAC | 134 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.