| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | $526 | $17K | 9.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS &ASSOC LLC | PO BOX 27097 PHOENIX, AZ 85061 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 0.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS & ASSOCIATES LLC | P. O. BOX 27097 PHOENIX, AZ 85061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15K | $3K | $18K | 16.36% |
| NOAH OROPEZA3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $3K | $9K | 8.25% |
| BRIAN DOUGLAS SCHROEDER3 | 16356 N. THOMPSON PEAK PKWY SCOTTSDALE, AZ 85260 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $997 | $3K | 2.54% |
| LISA ANN GUERTIN3 | 4605 E GROVERS AVE PHOENIX, AZ 85032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $70 | $3K | 2.36% |
| JAMES D THRESHER3 | 1316 E NIGHTINGALE LANE GILBERT, AZ 85298 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $1K | $2K | 2.01% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM RALPH DECKER | 2163 W VILLAGE DR PHOENIX, AZ 85023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $454 | $2K | 1.56% |
| DONNA JEAN NEUZIL3 | 15022 W MONTEREY WAY GOODYEAR, AZ 85395 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $253 | $2K | 1.49% |
| MIRANDELLY HERNANDEZ3 | 6054 N 30TH AVE PHOENIX, AZ 85017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $327 | $2K | 1.47% |
| DESIREE RENEE SALMON3 | 800 W WILLIS RD APT 1159 CHANDLER, AZ 85286 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $32 | $1K | 1.22% |
| JAMES THOMAS JOBLON3 | 1 N CENTRAL AVE PHOENIX, AZ 85004 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $280 | $511 | $791 | 0.73% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $478 | — | $478 | 0.44% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: KERWIN VAUGHN BROWN | 1939 E MISSOURI AVE APT 5 PHOENIX, AZ 85016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $140 | — | $140 | 0.13% |
| DEBBIE L ABRAHAM3 | PO BOX 27097 PHOENIX, AZ 85061 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $123 | — | $123 | 0.11% |
| OMAR LEON3 | 3124 N 21ST STREET PHOENIX, AZ 85016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.04% |
| BRETT WELTY INSURANCE AGENCY INC3 | 5675 RUFFIN RD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.03% |
| CBS INSURANCE SERVICES LLC3 | 5675 RUFFIN RD SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.02% |
| JB & H LLC3 | 8707 E SAGUARDO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $4 | $23 | 0.02% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| MICHAEL SANTISTEVAN FINANCIAL SERVI3 | 222 W MOUNTAIN SAGE DR PHOENIX, AZ 85045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
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 | 184 | 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) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $173K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $173K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $282K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $173K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 466 | $173K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 159 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 466 | — |
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.