| 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 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21K | $329 | $22K | 5.92% |
| BST COMPANIES INC3 Filed as: BST COMPANIES | 481 EAST DOWNTOWN STREET TUCSON, AZ 85701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $2K | $13K | 3.64% |
| JB & H LLC3 | 8707 E SAGUARO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $229 | $8K | 2.14% |
| LORENZA TORRES3 | 9636 E PASEO SAN BERNARDO DRIVE TUCSON, AZ 85747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $179 | $5K | 1.30% |
| PAUL A BYNUM3 Filed as: PAUL A. BYNUM | PO BOX 12306 TUCSON, AZ 85732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $24 | $3K | 0.69% |
| EC BENEFITS INC3 | 8038 S. 38TH PLACE PHOENIX, AZ 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1 | $2K | 0.59% |
| R AND T FIGUEROA LLC3 Filed as: R & T FIGUEROA LLC | 6415 SOUTH VALENCIA RANCH ROAD TUCSON, AZ 85735 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $112 | $2K | 0.55% |
| CAROL JEAN HALL3 | PO BOX 15158 TUCSON, AZ 85708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $113 | $2K | 0.49% |
| JULIE ANN MEADE3 Filed as: JULIE MEADE | 63 REGENCY PLACE HAYWARD, CA 94544 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.30% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $934 | $120 | $1K | 0.29% |
| MARINA C LOVE3 | 5470 W WHIPPAIL CT MARANA, AZ 85658 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $603 | $42 | $645 | 0.18% |
| REBECCA J MERRITT3 | 927 EAST KEIM DRIVE PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $383 | $7 | $390 | 0.11% |
| ISAACSON INSURANCE AGENCY LLC3 | 345 CONSTITUTION WAY NORTH SALT LAKE, UT 84054 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $275 | $42 | $317 | 0.09% |
| SHAWN JEFFERY WARREN3 | 6908 EAST MORELAND SCOTTSDALE, AZ 85257 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $193 | $90 | $283 | 0.08% |
| SHERRI M HOPKINS INS AGENCY3 | 5818 SOUTH 900 EAST UNIT 1 MURRAY, UT 84121 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $179 | $26 | $205 | 0.06% |
| JOSEPH QUINTANA3 | 27 N. COUNTRY CLUB DRIVE PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $110 | — | $110 | 0.03% |
| LUIS ENRIQUE VALDEZ3 | 6515 S STAR RIDGE PLACE TUCSON, AZ 85757 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | $4 | $92 | 0.03% |
| MARK MARQUEZ3 | 11680 E. CARON STREET SCOTTSDALE, AZ 38017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $23 | $39 | 0.01% |
| TIM VINCENT INS AGY INC3 Filed as: TIM VINCENT INS AGENCY INC | 1124 W SOUTH JORDAN PARKWAY SOUTH JORDAN, UT 84095 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $9 | $21 | 0.01% |
| XOCHITL ZORAYDA ARREOLA3 | 6310 W NEZ PERCE PHOENIX, AZ 85043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.01% |
| STEVEN J FARRINGTON3 | 902 WEST HALSTEAD DR NORTH SALT LAKE, UT 84054 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $2 | $8 | 0.00% |
| DEBORAH KNICKERBOCKER3 | PO BOX 823 CORTARO, AZ 85004 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $31K | — | $31K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $23K | — | $23K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $189 | $3K | 3.81% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED HEALTHCARE INSURANCE COMPANY | $8K | $239 | $9K | 12.36% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $680K |
| METROPOLITAN LIFE INS COMPANY EIN 13-5581829 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $26K |
| CBIZ BENEFITS AND INS SERVICES INC EIN 31-1582098 BROKER | Other commissions Service code 55 | — | $0 |
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 | 1,058 | 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) | 1,058 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 982 | $146K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 982 | $70K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,058 | $314K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,056 | $258K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,056 | $151K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 982 | $70K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 595 | $364K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,058 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.