| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 | 25 BILTMORE CIRCLE SUITE D-144 PHOENIX, AZ 85016 | DELTA DENTAL OF ARIZONA | $7K | — | $7K | 9.65% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | ARIZONA, INC. 2525 E AZ BILTMORE CIR. STE. D144 PHOENIX, AZ 850162111 | VISION SERVICE PLAN | $764 | — | $764 | 6.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK, GOULD & ASSOCIATES, INC. | 3800 N CENTRAL AVENUE FLOOR 9 PHOENIX, AZ 850121979 | VISION SERVICE PLAN | $105 | — | $105 | 0.87% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | 2525 E ARIZONA BILTMORE CIRCLE PHOENIX, AZ 85016 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $517 | — | $517 | 8.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES, INC. | 3800 N. CENTRAL AVENUE 9TH FLOOR PHOENIX, AZ 85012 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $33 | $4 | $37 | 0.63% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | ARIZONA, INC. 7901 N 16TH STREET, SUITE 200 PHOENIX, AZ 85020 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $777 | — | $777 | 14.99% |
| EMPLOYEE BENEFITS INTERNATIONAL3 | ARIZONA, INC. 7901 N 16TH STREET, SUITE 200 PHOENIX, AZ 85020 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $553 | — | $553 | 15.01% |
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 | 217 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ARIZONA | 126 | $77K |
| Vision | VISION SERVICE PLAN | 106 | $12K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 84 | $6K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 11 | $5K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 84 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.