| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BENEFITS GROUP | 6900 E INDIAN SCHOOL RD. STE 100 SCOTTSDALE, AZ 852513824 | METROPOLITAN LIFE INSURANCE COMPANY | $186K | $0 | $186K | 3.73% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK INC. | 2122 KRATKY RD. ST. LOUIS, MD 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $59K | $0 | $59K | 10.07% |
| DAVISON BENEFITS GROUP LLC3 | 6900 E INDIAN SCHOOL RD. STE 100 SCOTTSDALE, AZ 85251 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $59K | $0 | $59K | 10.07% |
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BENEFITS GROUP | 6900 E. INDIAN SCHOOL RD. SCOTTSDALE, AZ 85251 | EYEMED VISION CARE | $16K | $0 | $16K | 4.36% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC | 2325 E CAMELBACK RD SUITE 600 PHOENIX, AZ 85016 | NATIONAL UNION FIRE INS CO PITTSBURGH PA | $5K | $0 | $5K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSMART BENEFIT SOLUTIONS EIN 75-1857307 NETWORK ADMINISTRATOR | Other fees Service code 99 | — | $1.1M |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NETWORK ADMINISTRATOR | Other fees Service code 99 | — | $252K |
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 NETWORK ADMINISTRATOR | Other fees Service code 99 | — | $212K |
| DAVISON BENEFITS GROUP, INC EIN 86-0936245 BROKER | Insurance agents and brokers Service code 22 | — | $180K |
| AETNA BEHAVIORAL HEALTH, LLC CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $80K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $64K |
| AMERICAN HEALTH GROUP EIN 86-0494854 CONTRACT ADMINISTRATOR | Other fees Service code 99 | — | $26K |
| HEALTH AND HUMAN RESOURCE CENTER, I EIN 33-0052273 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVE. RSAA HARTFORD, CT 06156 | $11K |
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 | 4,087 | 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) | 4,087 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 11,626 | $5.0M |
| Vision | EYEMED VISION CARE | 7,639 | $376K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 11,626 | $5.0M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 11,626 | $5.0M |
| Other(6 contracts, 6 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 11,626 | $5.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,626 | — |
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.