| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | BLUE CROSS BLUE SHIELD OF ARIZONA | $44K | — | $44K | 6.04% |
| DONNA MARIE STOLL3 | 502 BOB LITTLE ROAD PANAMA CITY, FL 32404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $142 | $6K | 6.15% |
| TRANS CITY INSURANCE AGENCY3 | 7500 EAST MCDONALD DRIVE SCOTTSDALE, AZ 85250 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 5.58% |
| MARINA C LOVE3 | 3711 W SPINNAKER LN TUCSON, AZ 85742 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $295 | $4K | 3.44% |
| JEFFERY MICHAEL DORN3 | 19621 N 36STH ST PHOENIX, AZ 85050 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $847 | $457 | $1K | 1.26% |
| PAUL BYNUM3 | PO BOX 12306 TUSCON, AZ 85732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $68 | $1K | 1.22% |
| MARQUEZ BENEFIT GROUP LLC3 | 11225 NORTH 28TH DR PHOENIX, AZ 85029 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $464 | $300 | $764 | 0.74% |
| SUSAN HENDRICKS3 | 6718 N PALM CANYON DR PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $727 | $20 | $747 | 0.72% |
| JAZZLENA BROOKE PERALTA3 | 5509 W PARK ST LAVEEN, AZ 85339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $717 | — | $717 | 0.69% |
| MARK MARQUEZ3 | 11225 NORTH 28TH DR PHOENIX, AZ 85029 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $271 | $349 | $620 | 0.60% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $488 | $39 | $527 | 0.51% |
| JEFFREY THOMAS3 | P.O. BOX 11312 TEMPE, AZ 85284 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $434 | $33 | $467 | 0.45% |
| EDUARDO BARAJAS3 | 1703 W NATAL AVE MESA, AZ 85202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $309 | $6 | $315 | 0.30% |
| JOHN P ROMANUCCI3 Filed as: JOHN P ROMANUCCUI | 10524 E 36TH ST YUMA, AZ 85365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | $104 | $182 | 0.18% |
| MONIKA RENCHER3 | 629 NORTH MESA DR MESA, AZ 85201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | $3 | $57 | 0.05% |
| JAMES D THRESHER3 | 1316 E NIGHTINGALE LANE GILBERT, AZ 85298 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $33 | $56 | 0.05% |
| REBECCA J MERRITT3 | 927 EAST KEIM DR PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.05% |
| JOSEPH QUINTANA3 | 27 N COUNTRY CLUB DR PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.05% |
| KENT BISWANGER3 | 8134 W ACOMA DR PEORIA, AZ 85381 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $22 | $45 | 0.04% |
| TAMARA DAWN BELCHER3 | 493 MILLER AVE EVANSTON, WY 82930 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.03% |
| PECK FINANCIAL SERVICES INC3 | 27566 N 98TH LN PEORIA, AZ 85383 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.03% |
| LEOBARDO J PINEDA3 | 1451 W HAWKEN WAY CHANDLER, AZ 85286 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.03% |
| MANUEL TORRES3 | 20235 N CAVE CREEK RD PHOENIX, AZ 85024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $5 | $21 | 0.02% |
| LAURA M COX3 | 1501 E SEQUOIA DR PHOENIX, AZ 85024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| EC BENEFITS INC3 | 8038 S 38TH PL PHOENIX, AZ 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| STEVEN J FARRINGTON3 Filed as: STEVEN FARRINGTON | 902 WEST HALSTEAD DR NORTH SALT LAKE, UT 84054 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| PATTI A VINCENT3 | 3489 WEST 10305 SOUTH SOUTH JORDAN, UT 84095 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| AHG ENTERPRISES LLC3 | 5702 E CHARTER OAK RD SCOTTSDALE, AZ 85254 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 850121979 | UNITED CONCORDIA INSURANCE COMPANY | $4K | $1K | $5K | 12.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 850121979 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $5K | 22.25% |
| CSA GENERAL INSURANCE AGENCY3 | 2840 W LAS PALMARITAS PHOENIX, AZ 85021 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 16.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 850121979 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $446 | $325 | $771 | 17.28% |
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 | 185 | 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) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 132 | $723K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 123 | $39K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 138 | $732K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 189 | $132K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 97 | $104K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 97 | $104K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 132 | $723K |
| Other(4 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 189 | $855K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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.