| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $1K | $5K | 20.34% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | AMERITAS LIFE INSURANCE CORP. | $2K | $90 | $2K | 14.71% |
| LH BENEFIT CONSULTANTS LLC3 | PO BOX 3944 PRESCOTT, AZ 86302 | AFLAC | $477 | $18 | $495 | 4.09% |
| JOHN DANELL CULP3 | PO BOX 264 CRANFILLS GAP, TX 76637 | AFLAC | $407 | — | $407 | 3.36% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $225 | — | $225 | 1.86% |
| MARY E CULP3 | PO BOX 264 CRANFILLS GAP, TX 76637 | AFLAC | $152 | $7 | $159 | 1.31% |
| ERIC PEDERSON3 | 1527 HUCKLEBERRY SPRINGS RD KNOXVILLE, TN 37914 | AFLAC | $80 | — | $80 | 0.66% |
| DOUGLAS R GRAY3 Filed as: DOUGLAS S KOHL | 5010 CAMINO DE LOS VIENTOS FLAGSTAFF, AZ 86004 | AFLAC | $76 | — | $76 | 0.63% |
| JARCEY RAUL RODRIGUEZ3 | 202 S 1ST AVE YUMA, AZ 85364 | AFLAC | $74 | — | $74 | 0.61% |
| JOHNSON INSURANCE SVS LLC3 | PO BOX 1630 SEDONA, AZ 86339 | AFLAC | $59 | — | $59 | 0.49% |
| NATHAN A WIGGINS3 | 11638 TORREY PINES DR AUBURN, CA 95602 | AFLAC | $53 | — | $53 | 0.44% |
| WILLIAM H LENBERG3 | 15141 CRESTVIEW CIR ROSEMOUNT, MN 55068 | AFLAC | $32 | — | $32 | 0.26% |
| GREGORY F STENZEL3 | 1249 KIOWA DR W GAINESVILLE, TX 76240 | AFLAC | $25 | — | $25 | 0.21% |
| PRESTON SHAUN DAVIS3 | 854 S SAN MARCOS DR APT 9C AOACHE JUNCTION, AA 85120 | AFLAC | $24 | — | $24 | 0.20% |
| TOM LEE KOCH3 | 695 ORCHARD COURSE DR LAS VEGAS, NV 89148 | AFLAC | $24 | — | $24 | 0.20% |
| TAMMY A PEDERSON3 | 1527 HUCKLEBERRY SPRINGS RD KNOXVILLE, TN 37914 | AFLAC | $21 | — | $21 | 0.17% |
| MARK HILL3 | 5188 E PARK VISTA DR TUCSON, AZ 85756 | AFLAC | $18 | — | $18 | 0.15% |
| MATTHEW R CALICOAT3 | 436 CLOVER HILL DR TIPP CITY, OH 45371 | AFLAC | $10 | $5 | $15 | 0.12% |
| SCOTT WEBB3 | 26729 N 91ST DR PEORIA, AZ 85383 | AFLAC | $12 | — | $12 | 0.10% |
| CATHY STEPHENSON-HILL3 | 5188 E PARK VISTA DR TUCSON, AZ 85756 | AFLAC | $10 | — | $10 | 0.08% |
| STEVEN D KOHLS3 | 1692 STATES ST PRESCOTT, AZ 86301 | AFLAC | $9 | — | $9 | 0.07% |
| PREFERRED MARKETING CORP3 | 744 E DENIM TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $2 | — | $2 | 0.02% |
| JEFFREY A KLEINMAN SR3 | 33202 N 46TH WAY CAVE CREEK, AZ 85331 | AFLAC | $2 | — | $2 | 0.02% |
| MICHAEL G GLADNICK3 | 3850 E BASELINE RD STE 116 MESA, AA 85206 | AFLAC | $2 | — | $2 | 0.02% |
| NATALIE MALHAM3 | 5822 N 13TH ST PHOENIX, AZ 85014 | AFLAC | $2 | — | $2 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 CLAIMS PROCESSING | Claims processing Service code 12 | — | $32K |
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 CLAIMS PROCESSING | Claims processing Service code 12 | — | $9K |
| HEALTH ADVOCATE EIN 23-3080019 EAP PROVIDER | Other services Service code 49 | — | $5K |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE CORP. | 146 | $13K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 136 | $25K |
| Short-term disability | AFLAC | 14 | $12K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 136 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.