| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FBC SERVICES INC3 | 7639 E PINNACLE PEAK RD SUITE 100 SCOTTSDALE, AZ 85255 | BLUE CROSS BLUE SHIELD OF ARIZONA | $53K | — | $53K | 2.73% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVCS LLC | 501 OFFICE CENTER DR SUITE 215 FORT WASHI, PA 19034 | BLUE CROSS BLUE SHIELD OF ARIZONA | $13K | — | $13K | 0.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FI 9 PHOENIX, AZ 85012 | DELTA DENTAL OF ARIZONA | $6K | — | $6K | 3.51% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVCS LLC | 7639 E PINNACLE PEAK RD #100 SCOTTSDALE, AZ 85255 | DELTA DENTAL OF ARIZONA | $6K | — | $6K | 3.35% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF AZ | 2800 N CENTRAL AVE #1100 PHOENIX, AZ 85004 | DELTA DENTAL OF ARIZONA | $4K | — | $4K | 2.51% |
| FBC SERVICES INC3 Filed as: FBC INS BENEFITS & CONSULTANTS | 14201 N 87TH ST #D141 SCOTTSDALE, AZ 85260 | DELTA DENTAL OF ARIZONA | $1K | — | $1K | 0.84% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 7639 E PINNACLE PEAK RD STE 100 SCOTTSDALE, AZ 85255 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 6.60% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS OF ARIZONA | 2800 N CENTRAL AVE SUITE 1100 PHOENIX, AZ 85004 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 2.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FI 9 PHOENIX, AZ 85012 | DELTA DENTAL OF ARIZONA | $729 | — | $729 | 4.44% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVCS LLC | 7639 E PINNACLE PEAK RD #100 SCOTTSDALE, AZ 85255 | DELTA DENTAL OF ARIZONA | $538 | — | $538 | 3.28% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF AZ | 2800 N CENTRAL AVE #1100 PHOENIX, AZ 85004 | DELTA DENTAL OF ARIZONA | $404 | — | $404 | 2.46% |
| FBC SERVICES INC3 Filed as: FBC INS BENEFITS & CONSULTANTS | 14201 N 87TH ST #D141 SCOTTSDALE, AZ 85260 | DELTA DENTAL OF ARIZONA | $130 | — | $130 | 0.79% |
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 | 394 | 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) | 394 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 394 | $1.9M |
| Dental | DELTA DENTAL OF ARIZONA | 370 | $166K |
| Vision | DELTA DENTAL OF ARIZONA | 273 | $16K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 51 | $64K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 394 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 394 | — |
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.