| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 9.92% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $78 | $78 | 0.03% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AMERITAS LIFE INSURANCE CORP | $8K | $3K | $11K | 6.60% |
| SCOTT WOOD3 Filed as: SCOTT KOSTEL | 9566 E WINDROSE DR. SCOTTDALE, AZ 85260 | AFLAC | $7K | $205 | $8K | 8.80% |
| BRYAN G CORBIN LLC3 Filed as: BRYAN G CORBIN | 6950 SW HAMPTON ST STE 260 TIGARD, OR 97223 | AFLAC | $1K | — | $1K | 1.40% |
| RYAN KADAVY3 | 8542 W FOOTHILL DR PEORIA, AZ 85382 | AFLAC | $1K | $48 | $1K | 1.38% |
| BRYAN G CORBIN LLC3 | 6950 SW HAMPTON ST STE 260 TIGARD, OR 97223 | AFLAC | $609 | — | $609 | 0.71% |
| BRYAN G CORBIN LLC3 | 6950 SW HAMPTON ST STE 260 TIGARD, OR 97223 | AFLAC | $571 | — | $571 | 0.66% |
| K CONSULTING LLC3 | 1732 S CONGRESS AVE UNIT 207 PALM SPRINGS, FL 33461 | AFLAC | $520 | — | $520 | 0.60% |
| CHRISTOPHER E FISCHER3 | 5300 OAKBROOK PKWY STE 300 NORCROSS, GA 30093 | AFLAC | $434 | — | $434 | 0.50% |
| JAMI GONZALEZ3 | 10224 N 66TH DR GLENDALE, AZ 85302 | AFLAC | $233 | — | $233 | 0.27% |
| MARIA MULLIGAN3 | 15131 W DYNAMITE BLVD SUN CITY WEST, AZ 85387 | AFLAC | $219 | — | $219 | 0.25% |
| JASON ELIJAH ANGEL3 | 35468 N SHORTHORN TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $197 | $13 | $210 | 0.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | AFLAC | $194 | — | $194 | 0.23% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT GUTHRIE | 14227 N 14TH ST PHOENIX, AZ 85022 | AFLAC | $175 | — | $175 | 0.20% |
| RAYMOND MULLIGAN3 | 8765 W KELTON LN BLDG B1 PEORIA, AZ 85382 | AFLAC | $168 | — | $168 | 0.19% |
| JASON ELIJAH ANGEL3 | 2550 W UNION HILLS DR STE 350 PHOENIX, AZ 85027 | AFLAC | $125 | $23 | $148 | 0.17% |
| THE JACOBI GROUP LLC3 | PO BOX 72105 PHOENIX, AZ 85050 | AFLAC | $116 | — | $116 | 0.13% |
| MARK MARQUEZ3 Filed as: MARK A MARQUEZ | 8601 N BLACK CANYON HWY STE 209 PHOENIX, AZ 85021 | AFLAC | $110 | — | $110 | 0.13% |
| ORIN LEE WILLIAMS3 | 313 N CORRINE DR GILBERT, AZ 85234 | AFLAC | $95 | — | $95 | 0.11% |
| RAFAEL CHAVARIN3 | 8605 W MAGNOLIA ST TOLLESON, AZ 85353 | AFLAC | $89 | — | $89 | 0.10% |
| GREGORY STENZEL3 | 1249 KIOWA DR W GAINESVILLE, TX 76240 | AFLAC | $87 | — | $87 | 0.10% |
| NED BILECKI3 | PO BOX 27567 TEMPE, AZ 85285 | AFLAC | $76 | — | $76 | 0.09% |
| RUSSELL M FERREE3 Filed as: RUSSELL FERREE | 17804 N PHOENICAN DR. SURPRISE, AZ 85374 | AFLAC | $68 | — | $68 | 0.08% |
| JEANNETTE E FATHERREE3 Filed as: JEANNETTE DURRANI | 14835 1ST AVE PHOENIX, AZ 85023 | AFLAC | $53 | — | $53 | 0.06% |
| SCOTT WEBB3 | 26729 N 91ST DR PEORIA, AZ 85383 | AFLAC | $42 | — | $42 | 0.05% |
| BRYNA TUCKER3 | 24654 N LAKE PLEASANT PKWY 103-465 PEORIA, AZ 85383 | AFLAC | $42 | — | $42 | 0.05% |
| ANNE STRONG3 Filed as: ANNE L STRONG | 1482 E TASCAL LOOP TUCSON, AZ 85737 | AFLAC | $41 | — | $41 | 0.05% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 33202 N 46TH WAY CAVE CREEK, AS 85331 | AFLAC | $40 | — | $40 | 0.05% |
| JUDI HAAS3 | 11602 N SPOTTED HORSE WAY FOUNTAIN HILLS, AZ 85268 | AFLAC | $31 | — | $31 | 0.04% |
| APRIL L FARRELL3 | 1910 S STAPLEY DR STE 221 MESA, AZ 85204 | AFLAC | $29 | — | $29 | 0.03% |
| DONNA BOYER3 | 4376 E 1050TH AVE OBLONG, IL 62449 | AFLAC | $28 | — | $28 | 0.03% |
| JAMES HUNT3 | 15010 N 61ST PL SCOTTSDALE, AZ 85254 | AFLAC | $27 | — | $27 | 0.03% |
| HEALTHCARE NETWORKS OF AMERICA3 | 6127 S RAINBOW BLVD SUITE 100 LAS VEGAS, NV 89118 | AFLAC | $26 | — | $26 | 0.03% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | AFLAC | $20 | — | $20 | 0.02% |
| WILLIAM J SHARP3 Filed as: WILLIAM SHARP | 17836 N 43RD WAY PHOENIX, AZ 85032 | AFLAC | $20 | — | $20 | 0.02% |
| JENNIFER MATHER3 | 2664 N ROCA MESA, AZ 85213 | AFLAC | $19 | — | $19 | 0.02% |
| CRUSADER INSURANCE INC3 | 20516 80TH LN PEORIA, AZ 85382 | AFLAC | $18 | — | $18 | 0.02% |
| ALFREDO VARGAS3 | 6230 N FLORENCE AVE LITCHFIELD PARK, AZ 85340 | AFLAC | $17 | — | $17 | 0.02% |
| M & O AGENCIES INC3 | 1835 S EXTENSION RD MESA, AZ 85210 | AFLAC | $17 | — | $17 | 0.02% |
| DIANA JACKSON3 | 325 LINDEN LN MATTOON, IL 61938 | AFLAC | $16 | — | $16 | 0.02% |
| DONNA NORTHRUP3 | 2534 E BLANTON DR TUCSON, AZ 85716 | AFLAC | $14 | — | $14 | 0.02% |
| KIMBERLY J RODRIGUEZ3 | 37057 S GAMBEL QUAIL DR MARANA, AZ 85658 | AFLAC | $12 | — | $12 | 0.01% |
| PREFERRED MARKETING CORP3 | 744 E DENIM TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $10 | — | $10 | 0.01% |
| J M ELLWOOD3 Filed as: JM ELLWOOD | 8220 E SAN MIGUEL AVE SCOTTSDALE, AZ 85250 | AFLAC | $10 | — | $10 | 0.01% |
| ADAM LABBE3 | 22974 S 210 ST QUEEN CREEK, AZ 85142 | AFLAC | $10 | — | $10 | 0.01% |
| BOBBY JONES3 | 1831 E DONNER DR. PHOENIX, AZ 85042 | AFLAC | $10 | — | $10 | 0.01% |
| LAUREL L HARLOW3 Filed as: LAUREL HARLOW | 2030 W BASELINE RD STE 182 PHOENIX, AZ 85041 | AFLAC | $8 | — | $8 | 0.01% |
| GARY W JOHNSON3 Filed as: GARY JOHNSON | 210 CAMPBELL CIR MT JULIET, TN 37122 | AFLAC | $8 | — | $8 | 0.01% |
| ELLEN R SCHROEDER3 Filed as: ELLEN SCHROEDER | 441 DUNEDIN WAY GLASGOW, KY 42141 | AFLAC | $8 | — | $8 | 0.01% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 4470 WOODMAN AVE UNIT 303 SHERMAN OAKS, CA 91423 | AFLAC | $7 | — | $7 | 0.01% |
| MARK HILL3 | 5188 PARK VISTA DR. TUCSON, AZ 85756 | AFLAC | $7 | — | $7 | 0.01% |
| VIRGINA HUNT3 | 15010 N 61ST PL SCOTTSDALE, AZ 85254 | AFLAC | $7 | — | $7 | 0.01% |
| JULIE KICKER3 | PO BOX 11825 CASA GRANDE, AZ 85130 | AFLAC | $7 | — | $7 | 0.01% |
| SHANE FAIRCHILD3 | 13454 W PORT ROYALE LN SURPRISE, AZ 85379 | AFLAC | $7 | — | $7 | 0.01% |
| NICOLE E BRINDLE3 Filed as: NICOLE BRINDLE | 3933 E ROSEMONTE DR. PHOENIX, AZ 85050 | AFLAC | $5 | — | $5 | 0.01% |
| TIMOTHY KNEIDEL3 | 28631 N 45TH WAY CAVE CREEK, AZ 85331 | AFLAC | $5 | — | $5 | 0.01% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $5 | — | $5 | 0.01% |
| NATALIE MALHAM3 | 5822 N 13TH ST PHOENIX, AZ 85014 | AFLAC | $5 | — | $5 | 0.01% |
| GARY A YARBROUGH3 Filed as: GARY YARBROUGH | 1436 N HIGLEY RD #100 GILBERT, AZ 85234 | AFLAC | $5 | — | $5 | 0.01% |
| ZAKERY HARLOW3 | 2030 W BASELINE RD SUITE 182-17062 PHOENIX, AZ 85206 | AFLAC | $5 | — | $5 | 0.01% |
| BRITTON JOHNSON3 Filed as: BRITTON L JOHNSON | 3220 N ACADEMY BLVD STE 1 COLORADO SPRINGS, CO 80917 | AFLAC | $5 | — | $5 | 0.01% |
| JEFFERY S GIBSON3 Filed as: JEFFERY GIBSON | 4030 TATES CREEK RD APT 1004 CONSHOHOCKEN, PA 40517 | AFLAC | $4 | — | $4 | 0.00% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 33202 N 46TH WAY CAVE CREEK, AZ 85331 | AFLAC | $4 | — | $4 | 0.00% |
| MERLE DALE HALL3 Filed as: MERLE HALL | 5500 W LAKE RIVER LN BOISE, ID 83703 | AFLAC | $4 | — | $4 | 0.00% |
| SANDRA L SARFF3 Filed as: SANDRA SARFF | 3811 E CHICO LN TUCSON, AZ 85739 | AFLAC | $3 | — | $3 | 0.00% |
| ARIZONA BENEFITS GROUP INC3 | 7600 N 15TH ST STE 290 PHOENIX, AZ 85020 | AFLAC | $3 | — | $3 | 0.00% |
| SUSAN MULLIGAN3 | 11569 SW DAVIES ROAD APT 2812 BEAVERTON, OR 97007 | AFLAC | $3 | — | $3 | 0.00% |
| SHAWN HOLTORF3 | 5522 W NORTHWOOD DR. GLENDALE, AZ 85310 | AFLAC | $2 | — | $2 | 0.00% |
| RONALD S SANDERS3 Filed as: RONALD SANDERS | 744 E DENIM TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $2 | — | $2 | 0.00% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $2 | — | $2 | 0.00% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $1 | — | $1 | 0.00% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 4910 CORPORATE DR NW STE G HUNTSVILLE, AL 35805 | AFLAC | $1 | — | $1 | 0.00% |
| JODIE GRAY3 | 127 HOLMES CREEK LANE LAYTON, UT 84041 | AFLAC | $0 | — | $0 | 0.00% |
| JOHN BURLEY3 | 3989 W ORANGEWOOD DR TUCSON, AZ 85741 | AFLAC | $0 | — | $0 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $861 | — | $861 | 2.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $73K |
| COMPSYCH EIN 35-3739783 EAP PROVIDER | Other services Service code 49 | — | $0 |
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 | 477 | 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) | 477 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP | 477 | $161K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP | 477 | $202K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $279K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $365K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $279K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 375 | $279K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 477 | — |
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.