| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | BLUE CROSS & BLUE SHIELD OF ARIZONA | $35K | — | $35K | 2.38% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3900 E. CAMELBACK RD SUITE 225 PHOENIX, AZ 85018 | BLUE CROSS & BLUE SHIELD OF ARIZONA | $29K | — | $29K | 1.99% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3101 NORTH CENTRAL AVENUE SUITE 290 PHOENIX, AZ 85012 | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | $4K | — | $4K | 3.56% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | $2K | — | $2K | 2.23% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 6.92% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | SUN LIFE ASSURANCE COMPANY OF CANADA | $908 | — | $908 | 3.89% |
No Schedule C service providers reported on this filing.
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 | 297 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF ARIZONA | 205 | $1.5M |
| Dental | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | 224 | $110K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS & BLUE SHIELD OF ARIZONA | 224 | $1.6M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 365 | $23K |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF ARIZONA | 205 | $1.5M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 365 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 365 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.