| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | DELTA DENTAL OF ARIZONA | $8K | $0 | $8K | 12.46% |
| HERSHENBERG & STONE-WALSH INSURANCE3 Filed as: HERSHENBERG, PAUL | 2131 E BROADWAY RD SUITE 29 TEMPE, AZ 85282 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 10.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $244 | $1K | 7.35% |
| HERSHENBERG & STONE-WALSH INSURANCE3 | 2131 E BROADWAY RD SUITE 29 TEMPE, AZ 85282 | AFLAC | $2K | $0 | $2K | 11.28% |
| BRAD M WHITE3 Filed as: BRAD WHITE | 10823 W LOUISE DR SUN CITY, AZ 85373 | AFLAC | $2K | $134 | $2K | 10.63% |
| DAVID R LATTIMER3 | 6605 N 93RD AVE GLENDALE, AZ 85305 | AFLAC | $643 | $13 | $656 | 3.57% |
| ALFREDO VARGAS3 | 6230 N FLORENCE AVE LITCHFIELD PARK, AZ 85340 | AFLAC | $591 | $31 | $622 | 3.39% |
| MELISSA A SCHOFIELD3 Filed as: MELISSA SCHOFIELD | 5552 W NORTHWOOD DR GLENDALE, AZ 85310 | AFLAC | $118 | $0 | $118 | 0.64% |
| CHELSEY PEITZ3 | 31113 N NORTH VALLEY PKWY APT 3036 PHOENIX, AZ 85085 | AFLAC | $84 | $18 | $102 | 0.56% |
| HEAVEN DAWN NORTH3 Filed as: HEAVEN NORTH | 631 W MAIN ST TIPP CITY, OH 45371 | AFLAC | $13 | $0 | $13 | 0.07% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $143 | $1K | 11.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | AVESIS INSURANCE INCORPORATED | $1K | $0 | $1K | 13.01% |
| HERSHENBERG & STONE-WALSH INSURANCE3 | 2131 E BROADWAY RD SUITE 29 TEMPE, AZ 85282 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 17.92% |
| BERNIERI PAUL3 | 13305 CROSS BAY BLVD OZONE PARK, NY 11417 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $485 | $0 | $485 | 6.17% |
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 | 191 | 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) | 191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ARIZONA | 191 | $66K |
| Vision | AVESIS INSURANCE INCORPORATED | 168 | $10K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 61 | $49K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 61 | $38K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 61 | $20K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 61 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.