| 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. | $6K | $851 | $7K | 11.32% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.13% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.98% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 9.56% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.69% |
| 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 | $462 | — | $462 | 3.80% |
| ANNALISA MARIE KURZ3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $274 | $124 | $398 | 3.28% |
| MARQUEZ BENEFIT GROUP LLC3 | 8601 N BLACK CANYON HWY PHOENIX, AK 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $87 | $47 | $134 | 1.10% |
| KELLIE GREENE VALDEZ3 | 8470 W CHARLESTON AVE PEORIA, AZ 85382 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | $20 | $122 | 1.00% |
| CHRISTINE SEMANA3 | 2410 W RUTHRAUFF RD. STE 110 TUCSON, AZ 85705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | $1 | $118 | 0.97% |
| DONNA MARIE STOLL3 | 502 BOB LITTLE RD. PARAMA CITY, FL 32404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | — | $92 | 0.76% |
| MARINA C LOVE3 Filed as: MARINA LOVE | 406 HOPKINS ST RIO RICO, AK 85648 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $89 | — | $89 | 0.73% |
| ROCIO PERALTA SANCHEZ3 | 2009 W ORANGE DR. PHOENIX, AZ 85015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.34% |
| BST COMPANIES INC3 Filed as: BST COMPANIES INC. | 319 N CAMERON VIEW PLACE TUCSON, AK 85745 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 0.30% |
| CASSANDRA EPSTEIN3 | 13874 CARLOW PARK DR. RIVERVIEW, FL 33579 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.21% |
| STEVEN ROBERT KURZ3 | 8611 N BLACK CANYON HWY PEORIA, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $4 | $21 | 0.17% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.11% |
| LUIS DANIEL RIVAS3 | 8603 W GOLDEN LN PEORIA, AZ 85345 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.03% |
| EC BENEFITS INC3 Filed as: EC BENEFITS | 8038 S 38TH PL PHOENIX, AZ 85381 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD. PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.02% |
| PECK FINANCIAL SERVICES INC3 | 27566 N 98TH LN PEORIA, AZ 85383 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $817 | — | $817 | 6.82% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF ARIZONA | $638 | — | $638 | 10.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $90K |
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 | 248 | 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) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP. | 248 | $64K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 239 | $18K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $70K |
| Short-term disability(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $82K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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.