| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA | 16220 N. SCOTTSDALE RD. STE. 600 SCOTTSDALE, AZ 85254 | AXIS INSURANCE COMPANY | $5K | — | $5K | 8.40% |
| MARK J MATSOCK3 Filed as: MARK J. MASTOCK & ASSOCIATES, INC. | 2400 E. AZ BILTMORE CIR #1100 PHOENIX, AZ 85016 | AXIS INSURANCE COMPANY | $427 | — | $427 | 0.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC. | 16220 N. SCOTTSDALE RD. STE. 600 SCOTTSDALE, AZ 85254 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 7.41% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES, INC. | 2400 E. ARIZONA BILTMORE CIR. STE. 1100 PHOENIX, AZ 85016 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 2.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA | 16220 N. SCOTTSDALE RD. SUITE 600 SCOTTSDALE, AZ 85254 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $301 | $2K | 14.02% |
| MARK METTILLE3 Filed as: MARK J. MATSOCK & ASSOCIATES, INC. | 2400 E. ARIZONA BILTMORE CIRCLE STE. 1100 PHOENIX, AZ 85016 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $468 | — | $468 | 2.73% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA | 16220 N. SCOTTSDALE RD. STE. 600 SCOTTSDALE, AZ 85254 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $129 | $1K | 13.58% |
| MARK METTILLE3 Filed as: MARK J. MATSOCK & ASSOCIATES, INC. | 2400 E. ARIZONA BILTMORE CIRCLE STE. 1100 PHOENIX, AZ 85016 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $266 | — | $266 | 2.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 N. SCOTTSDALE RD. STE. 600 SCOTTSDALE, AZ 85254 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $721 | $170 | $891 | 15.40% |
| MARK METTILLE3 Filed as: MARK J. MATSOCK & ASSOCIATES, INC. | 2400 E. ARIZONA BILTMORE CIRCLE STE. 1100 PHOENIX, AZ 85016 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $147 | — | $147 | 2.54% |
| MARK METTILLE3 Filed as: MARK J. MATSOCK & ASSOCIATES, INC. | 2400 E. AZ BILTMORE CIR #1100 PHOENIX, AZ 85016 | EYEMED VISION CARE | $64 | — | $64 | 1.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | — | BLUE CROSS BLUE SHIELD OF ARIZONA | $15K | — | $15K | 25635.00% |
| MARK METTILLE3 Filed as: MARK J. MATSOCK & ASSOCIATES, INC. | 2400 E. ARIZONA BILTMORE CIRCLE STE. 1100 PHOENIX, AZ 85016 | BLUE CROSS BLUE SHIELD OF ARIZONA | $3K | — | $3K | 5665.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | 16220 N. SCOTTSDALE RD. SUITE 600 SCOTTSDALE, AZ 85254 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $552 | $76 | $628 | 3694.12% |
| MARK METTILLE3 Filed as: MARK J. MATSOCK & ASSOCIATES, INC. | 2400 E. ARIZONA BILTMORE CIRCLE STE. 1100 PHOENIX, AZ 85016 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $122 | — | $122 | 717.65% |
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 | 60 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 60 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AXIS INSURANCE COMPANY | 60 | $56K |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 178 | $43K |
| Vision | EYEMED VISION CARE | 148 | $5K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 252 | $23K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 28 | $10K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 17 | $17 |
| Prescription drug | AXIS INSURANCE COMPANY | 52 | $56K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 252 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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.