| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRANS CITY INSURANCE AGENCY3 | 7500 EAST MCDONALD DRIVE SCOTTSDALE, AZ 85250 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 4.07% |
| MARINA C LOVE3 | 406 HOPKINS ST RIO RICO, AZ 85648 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 3.07% |
| DONNA MARIE STOLL3 | 502 BOB LITTLE ROAD PANAMA CITY, FL 32404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 2.31% |
| JB & H LLC3 | 8707 E SAGUARDO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $189 | $1K | 1.17% |
| PAUL A BYNUM3 | PO BOX 12306 TUCSON, AZ 85732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $38 | $1K | 1.03% |
| MARQUEZ BENEFIT GROUP LLC3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $767 | $369 | $1K | 0.99% |
| LYNN MENDOZA3 Filed as: LYNN MARIE MENDOZA | 1368 W 13TH ST YUMA, AZ 85364 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $797 | $49 | $846 | 0.73% |
| VICTOR FERREIRA3 | PO BOX 1372 VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $758 | — | $758 | 0.66% |
| SUSAN HENDRICKS3 | 6718 N PALM CANYON DR PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $499 | $6 | $505 | 0.44% |
| ESTEBAN TALAVERA3 | PO BOX 7286 SAN LUIS, AZ 85349 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $419 | — | $419 | 0.36% |
| MARIA LOURDES MENDOZA3 | 26443 SAND PALM CT. MORENO VALLEY, CA 92555 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $267 | $1 | $268 | 0.23% |
| JAMES D THRESHER3 | 1316 E NIGHTINGALE LANE GILBERT, AZ 85298 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | $155 | $212 | 0.18% |
| ANNALISA MARIE KURZ3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | $130 | $202 | 0.18% |
| JEFFREY THOMAS3 | P.O. BOX 11312 TEMPE, AZ 85284 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $197 | — | $197 | 0.17% |
| DAVID PEPIN3 | 9341 FORT BAYARD AVE LAS VEGAS, NV 89178 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | $80 | $183 | 0.16% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: KERWIN VAUGHN BROWN | 1939 E MISSOURI AVE APT 5 PHOENIX, AZ 85016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | $48 | $179 | 0.16% |
| ARTURO PADRON URBINA3 | 5320 VIA CHEPO APT 16 RIVERSIDE, CA 92507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $124 | — | $124 | 0.11% |
| NOAH OROPEZA3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | $64 | $121 | 0.10% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNARDINO, CA 92410 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 0.06% |
| TOWERS BENEFITS GROUP LLC3 | 20235 N CAVE CREEK RD PHOENIX, AZ 85024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $20 | $61 | 0.05% |
| DEBORAH RUSH KIMMONS3 | 37291 BOSLEY ST. INDIO, CA 92203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | $11 | $59 | 0.05% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.02% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.02% |
| CASSANDRA EPSTEIN3 | 13874 CARLOW PARK DR RIVERVIEW, FL 33579 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.02% |
| PECK FINANCIAL SERVICES INC3 | 27566 N 98TH LN PEORIA, AZ 85383 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.02% |
| LAURA M COX3 | 12943 E TORO ST DEWEY, AZ 86327 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| EC BENEFITS INC3 | 8038 S 38TH PL PHOENIX, AZ 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| JOHN P ROMANUCCI3 | 10524 E 36TH ST YUMA, AZ 85365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| REBECCA J MERRITT3 | 927 EAST KEIM DR PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| JEFFRY MICHAEL DORN3 | 20235 N CAVE CREEK RD PHOENIX, AZ 85024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| EDUARDO BARAJAS3 | 1703 W NATAL AVE MESA, AZ 85202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 850121979 | UNITED CONCORDIA INSURANCE COMPANY | $3K | — | $3K | 9.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 850121979 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $924 | $4K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK, GOULD & ASSOCIATES | 3800 NORTH CENTRAL AVE, FL 9 PHOENIX, AZ 85012 | FIDELITY SECURITY LIFE COMPANY | $2K | — | $2K | 15.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 850121979 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $417 | $209 | $626 | 15.00% |
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 | 111 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 97 | $34K |
| Vision | FIDELITY SECURITY LIFE COMPANY | 172 | $10K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 181 | $138K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 112 | $115K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 112 | $115K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 181 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.