| 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 452632886 | DELTA DENTAL OF ARIZONA | $3K | — | $3K | 5.13% |
| JULIE KICKER3 | PO BOX 11825 CASA GRANDE, AZ 85130 | AFLAC | $2K | $74 | $3K | 6.09% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $714 | — | $714 | 1.71% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | 160 W SANTA CLARA ST SUITE 450 SAN JOSE, CA 95113 | AFLAC | $611 | — | $611 | 1.47% |
| MICHAEL FATHERREE3 | 171 COUNTRY ROAD 1559 ALBA, TX 75410 | AFLAC | $325 | — | $325 | 0.78% |
| SANDRA L SARFF3 Filed as: SANDRA SARFF | 7090 N ORACLE RD TUCSON, AZ 85704 | AFLAC | $318 | — | $318 | 0.76% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $311 | — | $311 | 0.75% |
| ZAKERY HARLOW3 | 2960 N ACADEMY BLVD SUITE 101 COLORADO SPRINGS, CO 80917 | AFLAC | $173 | — | $173 | 0.42% |
| JOHN DOLLAR3 | 588 E WOLF HOLLOW DR CASA GRANDE, AZ 85122 | AFLAC | $149 | — | $149 | 0.36% |
| TULA BOYLES3 | 5227 N FAIRWAY HEIGHTS DR TUCSON, AZ 85749 | AFLAC | $142 | — | $142 | 0.34% |
| MARSHA L ECHOLS3 Filed as: MARSHA ECHOLS | PO BOX 594 THATCHER, AZ 85552 | AFLAC | $124 | — | $124 | 0.30% |
| JAMES HUNT3 | 15010 N 61ST PLACE SCOTTSDALE, AZ 85254 | AFLAC | $123 | — | $123 | 0.30% |
| BENEFIT INTELLIGENCE INC3 | 4862 E BASELINE RD SUITE 101 MESA, AZ 85206 | AFLAC | $110 | — | $110 | 0.26% |
| MARK HILL3 | PO BOX 85715 TUCSON, AZ 85754 | AFLAC | $104 | — | $104 | 0.25% |
| JASON ELIJAH ANGEL3 Filed as: JASON ANGEL | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $62 | $15 | $77 | 0.18% |
| SCOTT WEBB3 | 12366 W MILTON DRIVE PEORIA, AZ 85383 | AFLAC | $77 | — | $77 | 0.18% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $71 | — | $71 | 0.17% |
| LAUREL L HARLOW3 Filed as: LAUREL HARLOW | 6200 W ROAN PLACE TUCSON, AZ 85743 | AFLAC | $71 | — | $71 | 0.17% |
| JACOB C ECHOLS3 Filed as: JACOB ECHOLS | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $64 | — | $64 | 0.15% |
| NANCY L SIGL3 Filed as: NANCY SIGL | 8683 RAWHIDE LN SPC 1 WILTON, CA 95693 | AFLAC | $50 | — | $50 | 0.12% |
| CHERYL WILLS3 | 12801 ROSECRANS AVE APT 134 NORWALK, CA 90650 | AFLAC | $39 | — | $39 | 0.09% |
| J M ELLWOOD3 | 8220 S SAN MIGUEL AVE SCOTTSDALE, AZ 85250 | AFLAC | $37 | — | $37 | 0.09% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $36 | — | $36 | 0.09% |
| PREFERRED MARKETING CORP3 | 1194 E LAKEVIEW DR. SAN TAN VALLEY, AZ 85143 | AFLAC | $32 | — | $32 | 0.08% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LANE PHOENIX, AZ 85042 | AFLAC | $26 | — | $26 | 0.06% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 29622 N 21ST DR PHOENIX, AZ 85085 | AFLAC | $11 | $15 | $26 | 0.06% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 4910 CORPORATE DR NW STE G HUNTSVILLE, AL 35805 | AFLAC | $24 | — | $24 | 0.06% |
| ZAKERY HARLOW3 | 3204 N ACADEMY BLVD STE 130 COLORADO SPRINGS, CO 80917 | AFLAC | $21 | — | $21 | 0.05% |
| ZACHARY HARTMAN3 | 13820 SOUTH 44TH ST APT 1190 PHOENIX, AZ 85044 | AFLAC | $17 | — | $17 | 0.04% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 360 W HUBBARD ST APT 1105 CHICAGO, IL 60654 | AFLAC | $16 | — | $16 | 0.04% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 3420 E SHEA BLVD SUITE 168 PHOENIX, AZ 85028 | AFLAC | $10 | — | $10 | 0.02% |
| HEALTHCARE NETWORKS OF AMERICA3 | 6127 S RAINBOW BLVD SUITE 100 LAS VEGAS, NV 89118 | AFLAC | $9 | — | $9 | 0.02% |
| SHAWN HOLTORF3 | 5522 W NORTHWOOD DR GLENDALE, AZ 85310 | AFLAC | $9 | — | $9 | 0.02% |
| VIRGINIA RUTH HUNT3 | 15010 N 61ST PLACE SCOTTSDALE, AZ 85254 | AFLAC | $9 | — | $9 | 0.02% |
| SHARON MCKELVEY3 | 197 N NOTTINGHAM LANE LOT 3 PAYSON, AZ 85541 | AFLAC | $8 | — | $8 | 0.02% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $8 | — | $8 | 0.02% |
| NATALIE MALHAM3 | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $8 | — | $8 | 0.02% |
| JEFFREY S GIBSON3 Filed as: JEFFREY GIBSON | 4805 LAKE BROOK DR. SUITE 220 GLEN ALLEN, VA 23060 | AFLAC | $7 | — | $7 | 0.02% |
| VIRGINIA DIANE HALL3 | 5500 W LAKE RIVER LANE BOISE, ID 83703 | AFLAC | $6 | — | $6 | 0.01% |
| BRENDA S O BERRY3 Filed as: BRENDA BERRY | PO BOX 686 THATCHER, AZ 85552 | AFLAC | $5 | — | $5 | 0.01% |
| MARK K HASLEY3 Filed as: MARK HASLEY | 21732 N 86TH DR PEORIA, AZ 85382 | AFLAC | $2 | — | $2 | 0.00% |
| JOHN BURLEY3 | 3060 W CALLE LUCINDA TUCSON, AZ 85741 | AFLAC | $2 | — | $2 | 0.00% |
| JULIA ANN COAST3 Filed as: JULIA COAST | 1409 E MALIBU DR TEMPE, AK 85282 | AFLAC | $2 | — | $2 | 0.00% |
| TREVOR NORENBERG3 | 4552 LAHINCH ST RAPID CITY, SD 57702 | AFLAC | $1 | — | $1 | 0.00% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNOUGHTON | 1308 NATURE WALK BLVD SW HUNTSVILLE, AL 35824 | 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 | $5K | $1K | $6K | 19.25% |
| 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 | $1K | $5K | 19.28% |
| 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 | $583 | $2K | 14.47% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | EYEMED | $1K | — | $1K | 9.17% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $885 | $403 | $1K | 14.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSING | Claims processing Service code 12 | — | $53K |
| CBIZ BENEFITS AND INS SERVICES INC EIN 31-1582098 BROKER | Insurance agents and brokers Service code 22 | — | $45K |
| 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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF ARIZONA | 67 | $106K |
| Vision | EYEMED | 138 | $11K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $40K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 49 | $55K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 34 | $26K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 132 | $359K |
| Other(3 contracts, 2 carriers) | AFLAC | 127 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.