| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $31K | $412 | $32K | 13.39% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | 700 W 47TH ST KANSAS CITY, MO 64112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 14.68% |
| BST COMPANIES INC3 Filed as: BST COMPANIES INC. | 725 S FREMONT AVE TUCSON, AZ 85719 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $40 | $2K | 3.04% |
| JB & H LLC3 | 8707 E SAGUARDO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $49 | $1K | 1.90% |
| LORENZA TORRES3 | 9636 E PASEO SAN BERNARDO DR TUCSON, AZ 85747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $42 | $1K | 1.53% |
| MARY CATHERINE WILLIAMS3 Filed as: MARY WILLIAMS | 2950 S JAMAICA CT STE 302 AURORA, CA 80014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $63 | $1K | 1.53% |
| KIMBERLY PETERSON3 | 1860 S GOLDSMITH AVE MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $906 | $12 | $918 | 1.24% |
| MARQUEZ BENEFIT GROUP LLC3 | 8611 N BLACK CANYON HWY PHOENIX, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $566 | $349 | $915 | 1.24% |
| SHAWN JEFFERY WARREN3 Filed as: SHAWN JEFFREY WARREN | P.O. BOX 581 SCOTTSDALE, AZ 85252 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $155 | $195 | $350 | 0.47% |
| DESIREE RENEE SALMON3 Filed as: DESIREE SALMON | 800 W WILLIS RD APT 1159 CHANDLER, AZ 85286 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $241 | — | $241 | 0.33% |
| MARIA GRACIELA PAMANES3 | 1660 FORGAN WAY EL PASO, TX 79911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $194 | $18 | $212 | 0.29% |
| LUISA DE STEFANO3 | 138 BELVIDERE ST #A EL PASO, TX 79912 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $210 | — | $210 | 0.28% |
| REBECCA J MERRITT3 Filed as: REBECCA MERRITT | 927 EAST KEIM DR. PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $198 | — | $198 | 0.27% |
| MERKI BENEFITS ADMINISTRATION LLC3 Filed as: MERKI BENEFITS ADMINISTRATION, LLC | 326 VILLA CANTO EL PASO, TX 79920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $82 | $128 | 0.17% |
| ANNALISA MARIE KURZ3 | 8601 N. BLACK CANYON HWY PHOENIZ, AZ 85201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $70 | $110 | 0.15% |
| JILL HUGHES3 | 6510 TAMARA DR SALT LAKE CITY, UT 84129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | $6 | $99 | 0.13% |
| VINCENT TAYLOR ECHOLS3 Filed as: VINCENT ECHOLS | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | — | $92 | 0.12% |
| PAUL SCOTT MORRIS3 | 5272 S SWEETGRASS WAY BOISE, ID 83716 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | — | $91 | 0.12% |
| DENISE A MAXWELL3 | 3501 W TORANA DR MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | $11 | $80 | 0.11% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS, INC. | 509 SOUTH 4TH AVENUE BRIGHTWON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $26 | $66 | 0.09% |
| R AND T FIGUEROA LLC3 Filed as: R & T FIGUEROA LLC | 7569 S CARLISLE AVE TUCSON, AZ 85746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | — | $62 | 0.08% |
| EC BENEFITS INC3 | 8038 S 38TH PL PHOENIX, AZ 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | — | $61 | 0.08% |
| ORLANDO MERCADO3 | 326 VILLA CANTO EL PASO, TX 79920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | $5 | $58 | 0.08% |
| EDWARD JOSEPH CORBETT3 Filed as: EDWARD JOSEPH CORBET | 6185 S. PARIS STREET GREENWOOD VILLAGE, CO 80111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $14 | $54 | 0.07% |
| G ZUBIA ENTERPRISES INC3 Filed as: G ZUBIA ENTERPRISE INC | 2417 MONTANA AVE EL PASO, TX 79903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $18 | $37 | 0.05% |
| BRYN REID3 | 14701 MELCO ACE PARKER, CO 80134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $24 | $32 | 0.04% |
| JULIA MOORE3 | 9208 C ANDERSON DR. NW ALBUQUERQUE, NM 70820 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.03% |
| LIZA VALERIA DOMINGUEZ3 Filed as: LIZA DOMINGUEZ | 652 WIND RIVER EL PASO, TX 79932 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $5 | $18 | 0.02% |
| DAVID MCLEOD3 | 1207 SOUTH 4 MERKEL, TX 79536 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $3 | $16 | 0.02% |
| VANESSA CARRASCO3 | 1516 JIM COLBERT LANE EL PASO, TX 79936 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.02% |
| DANIEL ROJAS3 | 6680 CABANA DEL SOL EL PASO, TX 79911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.02% |
| PAM ANDERSON & ASSOCIATES INC3 | 23 COUNTRY RD 22 ESPANOLA, NM 87532 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.02% |
| JEFFREY GRAY3 Filed as: JEFFREY D. GRAY | 247 SW 13TH STREET ONTARIO, OR 97914 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $1 | $11 | 0.01% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD. PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| RITA RIBAS3 | 3624 MIMBRES LANE SANTA FE, NM 87507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| CUSTOM INSURANCE SPECIALISTS INC3 Filed as: CUSTOM INSURANCE SPECIALISTS INC. | 886 E 3200 N KAMAS, UT 84036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| LOIS FLEENER3 | 3196 IVORY DRIVE IDAHO FALLS, ID 83401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.01% |
| KEVIN E MONTOYA3 Filed as: KEVIN MONTOYA | 23 COUNTY ROAD 22 ESPANOLA, NM 87532 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.01% |
| STEVE G MONTOYA3 Filed as: STEVE MONTOYA | 23 COUNTRY ROAD 22 ESPANOLA, NM 87532 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| PAUL BYNUM3 | PO BOX 12306 TUCSON, AZ 85732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | $412 | $5K | 10.68% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 9.80% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $574 | $214 | $788 | 13.73% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 CLAIMS PROCESSOR | Contract Administrator; Named fiduciary; Direct payment from the plan; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $41K |
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 | 272 | 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) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 156 | $238K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 117 | $50K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 144 | $11K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 272 | $6K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 87 | $74K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 272 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.