| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT TOUCHE INC | 1050 W WASHINGTON ST STE 233 TEMPE, AZ 85281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.53% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $738 | $738 | 0.37% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT TOUCHE INC | 1050 W WASHINGTON ST STE 233 TEMPE, AZ 85281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.57% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $395 | $395 | 0.37% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT TOUCHE INC | 1050 W WASHINGTON ST STE 233 TEMPE, AZ 85281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $214 | $214 | 1.64% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $51 | $51 | 0.39% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX INC EIN 33-0441200 PHARMA BENEFIT MGMT | Claims processing; Float revenue; Other fees; Direct payment from the plan Service code 12 | — | $2.3M |
| UMR INC EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $235K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $34K |
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 | 529 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 529 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 529 | $199K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 529 | $14K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 529 | $106K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 549 | $827K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 529 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 549 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.