| 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 | 4.31% |
| MARINA C LOVE3 | 406 HOPKINS ST RIO RICO, AZ 85648 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 3.32% |
| MARQUEZ BENEFIT GROUP LLC3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $871 | $1K | $2K | 1.70% |
| DONNA MARIE STOLL3 | 502 BOB LITTLE ROAD PANAMA CITY, FL 32404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.61% |
| JB & H LLC3 | 8707 E SAGUARDO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $90 | $2K | 1.57% |
| ANNALISA MARIE KURZ3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $804 | $723 | $2K | 1.30% |
| PAUL A BYNUM3 | PO BOX 12306 TUCSON, AZ 85732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $34 | $1K | 1.20% |
| LYNN MENDOZA3 Filed as: LYNN MARIE MENDOZA | 1368 W 13TH ST YUMA, AZ 85364 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $2 | $1K | 1.10% |
| RENE ADRIAN RODRIGUEZ3 | 1814 E BELL RD UNIT 2009 PHOENIX, AZ 85022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $389 | $132 | $521 | 0.44% |
| SUSAN HENDRICKS3 | 6718 N PALM CANYON DR PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $513 | $6 | $519 | 0.44% |
| 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 | $230 | $48 | $278 | 0.24% |
| VICTOR FERREIRA3 | PO BOX 1372 VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $212 | — | $212 | 0.18% |
| JEFFREY THOMAS3 | P.O. BOX 11312 TEMPE, AZ 85284 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $194 | — | $194 | 0.16% |
| STEVEN ROBERT KURZ3 | 14640 N 90TH DRIVE PEORIA, AZ 85381 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $174 | — | $174 | 0.15% |
| ESTEBAN TALAVERA3 | PO BOX 7286 SAN LUIS, AZ 85349 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $121 | — | $121 | 0.10% |
| DAVID PEPIN3 | 9341 FORT BAYARD AVE LAS VEGAS, NV 89178 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | — | $90 | 0.08% |
| MANUEL ENRIQUE SCHAAR3 | 182 MONTEBELLO ST CHULA VISTA, CA 91910 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $46 | $79 | 0.07% |
| LUIS RAFAEL VALLE3 | 2354 CHATKA LANE SAN BERNARDINO, CA 92410 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.06% |
| NOAH OROPEZA3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $27 | $43 | 0.04% |
| JAMES D THRESHER3 | 1316 E NIGHTINGALE LANE GILBERT, AZ 85298 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $17 | $33 | 0.03% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.02% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.02% |
| CASSANDRA EPSTEIN3 | 13874 CARLOW PARK DR RIVERVIEW, FL 33579 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.02% |
| PECK FINANCIAL SERVICES INC3 | 27566 N 98TH LN PEORIA, AZ 85383 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.02% |
| MARIA LOURDES MENDOZA3 | 26443 SAND PALM CT. MORENO VALLEY, CA 92555 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.01% |
| LAURA M COX3 | PMB 221 TUCSON, AZ 85741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| TOWERS BENEFITS GROUP LLC3 | 20235 N CAVE CREEK RD PHOENIX, AZ 85024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| 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 | $4 | — | $4 | 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 | 12.85% |
| 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 | $1K | $4K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK, GOULD & ASSOCIATES | 3800 NORTH CENTRAL AVE PHOENIX, AZ 85012 | FIDELITY SECURITY LIFE COMPANY | $2K | — | $2K | 17.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 850121979 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $423 | $212 | $635 | 15.02% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 99 | $37K |
| Vision | FIDELITY SECURITY LIFE COMPANY | 149 | $10K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 178 | $143K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 102 | $118K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 102 | $118K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 178 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.