| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $42K | $2K | $44K | 11.46% |
| JULIE KICKER3 | PO BOX 11825 CASA GRANDE, AZ 85130 | AFLAC | $3K | $143 | $3K | 6.50% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $578 | $57 | $635 | 1.48% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $505 | — | $505 | 1.17% |
| SANDRA L SARFF3 Filed as: SANDRA SARFF | 7090 N ORACLE RD PMB 152 TUCSON, AZ 85704 | AFLAC | $309 | — | $309 | 0.72% |
| MICHAEL FATHERREE3 | 171 COUNTRY ROAD 1559 ALBA, TX 75410 | AFLAC | $291 | — | $291 | 0.68% |
| DAVID R LATTIMER3 Filed as: DAVID LATTIMER | 3029 N SONORAN HILLS MESA, AZ 85207 | AFLAC | $215 | — | $215 | 0.50% |
| ZAKERY HARLOW3 | 2960 N ACADEMY BLVD SUITE 101 COLORADO SPRINGS, CO 80917 | AFLAC | $175 | — | $175 | 0.41% |
| MARSHA L ECHOLS3 Filed as: MARSHA ECHOLS | PO BOX 594 THATCHER, AZ 85552 | AFLAC | $149 | — | $149 | 0.35% |
| JAMES HUNT3 | 15010 N 61ST PL SCOTTSDALE, AZ 85254 | AFLAC | $147 | — | $147 | 0.34% |
| JOHN DOLLAR3 | 588 E WOLF HOLLOW DR CASA GRANDE, AZ 85122 | AFLAC | $142 | — | $142 | 0.33% |
| TULA BOYLES3 | 5227 N FAIRWAY HEIGHTS DR TUCSON, AZ 85749 | AFLAC | $142 | — | $142 | 0.33% |
| BENEFIT INTELLIGENCE INC3 | 4862 E BASELINE RD SUITE 101 MESA, AZ 85206 | AFLAC | $131 | — | $131 | 0.30% |
| MARK HILL3 | 5188 E PARK VISTA DR. TUCSON, AZ 85756 | AFLAC | $75 | — | $75 | 0.17% |
| SCOTT WEBB3 | 26729 N 91ST DR PEORIA, AZ 85383 | AFLAC | $71 | — | $71 | 0.17% |
| LAUREL L HARLOW3 Filed as: LAUREL HARLOW | 6200 W ROAN PL TUCSON, AZ 85743 | AFLAC | $68 | — | $68 | 0.16% |
| JACOB C ECHOLS3 Filed as: JACOB ECHOLS | 3850 E BASELINE RD STE 116 MESA, AZ 85206 | AFLAC | $53 | — | $53 | 0.12% |
| J M ELLWOOD3 | 8220 E SAN MIGUEL AVE SCOTTSDALE, AZ 85250 | AFLAC | $44 | — | $44 | 0.10% |
| JASON ELIJAH ANGEL3 Filed as: JASON ANGEL | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $43 | — | $43 | 0.10% |
| NANCY L SIGL3 Filed as: NANCY SIGL | 8683 RAWHIDE LN SPC 1 WILTON, CA 95693 | AFLAC | $43 | — | $43 | 0.10% |
| PREFERRED MARKETING CORP3 | 744 E DENIM TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $39 | — | $39 | 0.09% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $38 | — | $38 | 0.09% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 4910 CORPORATE DR NW STE G HUNTSVILLE, AL 35805 | AFLAC | $36 | — | $36 | 0.08% |
| MARK HILL3 | PO BOX 85715 TUCSON, AZ 85754 | AFLAC | $29 | — | $29 | 0.07% |
| CHERYL WILLS3 | 12801 ROSECRANS AVE APT 134 NORWALK, CA 90650 | AFLAC | $26 | — | $26 | 0.06% |
| JASON ELIJAH ANGEL3 Filed as: JASON ANGEL | 504 S ABBEY WAY HOPKINSVILLE, KY 42440 | AFLAC | $22 | — | $22 | 0.05% |
| ZACHARY HARTMAN3 | 13820 S 44TH ST APT 1190 PHOENIX, AZ 85044 | AFLAC | $21 | — | $21 | 0.05% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LN PHOENIX, AZ 85042 | AFLAC | $20 | — | $20 | 0.05% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 1 W SUPERIOR ST APT 1301 CHICAGO, IL 60654 | AFLAC | $13 | — | $13 | 0.03% |
| HEALTHCARE NETWORKS OF AMERICA3 | 6127 S RAINBOW BLVD. STE 100 LAS VEGAS, NV 89118 | AFLAC | $11 | — | $11 | 0.03% |
| VIRGINIA RUTH HUNT3 Filed as: VIRGINIA HUNT | 15010 N 61ST PL SCOTTSDALE, AZ 85254 | AFLAC | $10 | — | $10 | 0.02% |
| SHAWN HOLTORF3 | 5522 W NORTHWOOD DR. GLENDALE, AZ 85310 | AFLAC | $9 | — | $9 | 0.02% |
| VIRGINA HALL3 | 5500 W LAKE RIVER LN BOISE, ID 83703 | AFLAC | $8 | — | $8 | 0.02% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD STE 116 MESA, AZ 85206 | AFLAC | $8 | — | $8 | 0.02% |
| NATALIE MALHAM3 | 3850 E BASELINE RD STE 116 MESA, AZ 85206 | AFLAC | $8 | — | $8 | 0.02% |
| JUSTIN WAYNE ECHOLS3 Filed as: JUSTIN ECHOLS | PO BOX 1283 THATCHER, AZ 85552 | AFLAC | $7 | — | $7 | 0.02% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 3420 E SHEA BLVD STE 168 PHOENIX, AZ 85028 | AFLAC | $6 | — | $6 | 0.01% |
| JEFFERY S GIBSON3 Filed as: JEFFERY GIBSON | 3009 HUNTON COTTAGE LN GLEN ALLEN, VA 23059 | AFLAC | $6 | — | $6 | 0.01% |
| SHARON MCKELVEY3 | 197 N NOTTINGHAM LN LOT 3 PAYSON, AZ 85541 | AFLAC | $6 | — | $6 | 0.01% |
| KELLY MCGARRY3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $5 | — | $5 | 0.01% |
| BRENDA S O BERRY3 Filed as: BRENDA BERRY | PO BOX 686 THATCHER, AZ 85552 | AFLAC | $5 | — | $5 | 0.01% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 33202 N 46TH WAY CAVE CREEK, AZ 85331 | AFLAC | $3 | — | $3 | 0.01% |
| JOHN BURLEY3 | 3989 W ORANGEWOOD DR TUCSON, AZ 85741 | AFLAC | $3 | — | $3 | 0.01% |
| FILIPE COELHO3 | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $2 | — | $2 | 0.00% |
| JULIE COAST3 | 1409 E MALIBU DR TEMPE, AZ 85282 | AFLAC | $2 | — | $2 | 0.00% |
| JEFFERY S GIBSON3 Filed as: JEFFERY GIBSON | 4805 LAKE BROOK DR STE 220 GLEN ALLEN, VA 23060 | 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 | 19.32% |
| 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 | 19.10% |
| 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 | $587 | $2K | 14.05% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | EYEMED | $998 | — | $998 | 10.16% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $820 | $398 | $1K | 14.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSING | Claims processing Service code 12 | — | $58K |
| 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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 82 | $382K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 82 | $425K |
| Vision | EYEMED | 142 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $41K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 43 | $58K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 34 | $29K |
| Other(3 contracts, 2 carriers) | AFLAC | 129 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.