| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | REGENCE BLUESHIELD | $4K | — | $4K | 0.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | PO BOX 730054 DALLAS, TX 75373 | METROPOLITAN LIFE INSURANCE COMPANY | $27K | $42 | $27K | 6.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | PO BOX 730054 DALLAS, TX 75373 | METROPOLITAN LIFE INSURANCE COMPANY | — | $6K | $6K | 1.40% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 7.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 NORTH SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 5.47% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $121 | $121 | 0.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 NORTH SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.93% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $89 | $89 | 0.07% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD. | 1750 EAST GOLF ROAD SUITE 140 CHICAGO, IL 60173 | VISION SERVICE PLAN | $862 | — | $862 | 1.86% |
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 | 972 | 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) | 972 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUESHIELD | 518 | $1.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,089 | $430K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 518 | $504K |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 891 | $249K |
| Short-term disability(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 891 | $249K |
| Long-term disability(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 891 | $249K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 518 | $458K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 518 | $458K |
| Other(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 891 | $249K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,089 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.