| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RW KING ASSICIATES INC3 | 1616 EAST INDIAN SCHOOL ROAD SUITE 420 PHOENIX, AZ 850163913 | HCC LIFE INSURANCE COMPANY | $7K | — | $7K | 3.00% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT TOUCHE INC | PO BOX 32702 TUCSON, AZ 857512702 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 6.74% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT TOUCHE INC | PO BOX 32702 TUCSON, AZ 857512702 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 6.09% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT TOUCHE INC | PO BOX 32702 TUCSON, AZ 85751 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 15.00% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT TOUCHE INC | PO BOX 32702 TUCSON, AZ 857512702 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.44% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT TOUCHE INC | PO BOX 32702 TUCSON, AZ 857512702 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.31% |
| LOVITT AND TOUCHE, INC.3 Filed as: LOVITT TOUCHE INC | PO BOX 32702 TUCSON, AZ 85751 | EMPLOYERS DENTAL SERVICES | $735 | — | $735 | 7.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSMART EIN 36-4099199 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $40K |
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 NETWORK ACCESS PROV | Other fees Service code 99 | — | $23K |
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 | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 142 | $245K |
| Dental(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $29K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $20K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $86K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 153 | $35K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $48K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 191 | $65K |
| 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."
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.