| 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 | AMERITAS LIFE INSURANCE CORP. | $4K | $489 | $4K | 11.35% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF ARIZONA | $750 | — | $750 | 8.21% |
| CHRISTINE SEMANA3 | 2410 W RUTHRAUFF RD. STE 110 TUCSON, AZ 85705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $214 | $2K | $2K | 20.66% |
| ANNALISA MARIE KURZ3 | 14640 N 90TH DR. PEORIA, AZ 85381 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $621 | $353 | $974 | 10.67% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | 700 W. 47TH ST. KANSAS CITY, MO 64112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $856 | — | $856 | 9.37% |
| MARQUEZ BENEFIT GROUP LLC3 | 8611 N BLACK CANYON HWY PHOENIX, AK 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $220 | $551 | $771 | 8.44% |
| VICKY REYES AND OTHER AGENTS3 Filed as: VICKY REYES | 8603 W GOLDEN LN PEORIA, AA 85345 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $214 | $231 | $445 | 4.87% |
| KELLIE GREENE VALDEZ3 | 8470 W CHARLESTON AVE PEORIA, AZ 85382 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $194 | $58 | $252 | 2.76% |
| ROCIO PERALTA SANCHEZ3 | 2009 W ORANGE DR. PHOENIX, AZ 85015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | — | $134 | 1.47% |
| DONNA MARIE STOLL3 | 502 BOB LITTLE RD. PARAMA CITY, FL 32404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 0.79% |
| MARINA C LOVE3 Filed as: MARINA LOVE | 406 HOPKINS ST RIO RICO, AK 85648 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 0.79% |
| BST COMPANIES INC3 Filed as: BST COMPANIES INC. | 425 S FREMONT AVE TUCSON, AK 85719 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.23% |
| LUIS DANIEL RIVAS3 | 8603 W GOLDEN LN PEORIA, AZ 85345 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $8 | $19 | 0.21% |
| CASSANDRA EPSTEIN3 | 13874 CARLOW PARK DR. RIVERVIEW, FL 33579 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.16% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.11% |
| EC BENEFITS INC3 Filed as: EC BENEFITS | 8038 S 38TH PL PHOENIX, AZ 85381 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.03% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD. PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| PECK FINANCIAL SERVICES INC3 | 27566 N 98TH LN PEORIA, AZ 85383 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $26K |
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 | 250 | 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) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP. | 250 | $36K |
| Vision | DELTA DENTAL OF ARIZONA | 197 | $9K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 12 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.