| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62683 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 10.00% |
| CSA GENERAL INSURANCE AGENCY3 | 2480 WEST LAS PALMARITAS DRIVE PHOENIX, AZ 85021 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 12.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 2375 EAST CAMELBACK ROAD PHOENIX, AZ 85016 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 3.60% |
| GENTRY INSURANCE INC3 Filed as: GENTRY INSUARANCE, INC. | 9140 WEST COOLBROOK AVENUE PEORIA, AZ 85382 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 1.88% |
| JEFFREY THOMAS3 | PO BOX 11312 TEMPE, AZ 85284 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 1.20% |
| SUSAN HENDRICKS3 | 6718 NORTH PALM CANYON DRIVE PHOENIX, AZ 85018 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 1.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA, INC. | UNKNOWN PHOENIX, AZ 85028 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.34% |
| GEORGE E GENTRY3 Filed as: GEORGE E. GENTRY | 9140 WEST COOLBROOK AVENUE PEORIA, AZ 85382 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.17% |
| DONNA MARIE STOLL3 Filed as: DONNA M. STOLL ANDOTHER AGENT | 502 BOB LITTLE ROAD PANAMA CITY, FL 32404 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.17% |
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 | 168 | 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) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 220 | $16K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 168 | $78K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 168 | $78K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 168 | $78K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 168 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.