| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | BLUE CROSS BLUE SHIELD OF ARIZONA | $30K | — | $30K | 4.59% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 951 YAMATO ROAD SUITE 200W BOCA RATON, FL 33431 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 10.57% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | 700 W 47TH ST. STE 1100 KANSAS CITY, MO 64112 | AMERITAS LIFE INSURANCE CORP. | $3K | $640 | $3K | 5.61% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | PO BOX 632886 CINNCINNATI, OH 45263 | CONTINENTAL AMERICAN INSURANCE COMPANY | $955 | — | $955 | 10.06% |
| DEBRA TORNBERG3 | 26065 N 68TH DR. PEORIA, AZ 85383 | CONTINENTAL AMERICAN INSURANCE COMPANY | $941 | — | $941 | 9.91% |
| JAMI GONZALEZ3 | 1207 E. EL CAMINO DR. PHOENIX, AZ 85020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $183 | — | $183 | 1.93% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT GUTHRIE | 14227 N 14TH ST PHOENIX, AZ 85022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $104 | — | $104 | 1.10% |
| PAMELA UTTER3 | 7750 W BOCA RATON RD PEORIA, AZ 85381 | CONTINENTAL AMERICAN INSURANCE COMPANY | $65 | — | $65 | 0.68% |
| GLEN GABLE3 | 2250 E MALLARD CT GILBERT, AZ 85234 | CONTINENTAL AMERICAN INSURANCE COMPANY | $36 | — | $36 | 0.38% |
| MICHAEL SHAUN DAGEN3 Filed as: MICHAEL DAGEN | 31661 N 131ST AVE. PEORIA, AZ 85383 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26 | — | $26 | 0.27% |
| DAVID R LATTIMER3 Filed as: DAVID LATTIMER | 8765 W KELTON LN BUILDING GB SUITE 210 PEORIA, AZ 85382 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26 | — | $26 | 0.27% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 337 JOLFFIE RD GRANT, AL 35747 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.17% |
| ROBERT LABONTE3 | 1659 W. SAN REMO GILBERT, AZ 85233 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.17% |
| EXEL I CARABALLO JR3 | PO BOX 80152 PHOENIX, AZ 85060 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | — | $11 | 0.12% |
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 | 159 | 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) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 90 | $657K |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 242 | $143K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 159 | $741K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $84K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $93K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $84K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 90 | $657K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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.