| 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 | $27K | — | $27K | 12.46% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | 700 W 47TH ST KANSAS CITY, MO 64112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 8.10% |
| BST COMPANIES INC3 Filed as: BST COMPANIES INC. | 319 N CAMERON VIEW PLACE TUCSON, AZ 85745 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $29 | $1K | 2.41% |
| JB & H LLC3 | 8707 E SAGUARDO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $54 | $1K | 2.26% |
| MARQUEZ BENEFIT GROUP LLC3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $247 | $314 | $561 | 0.94% |
| KIMBERLY PETERSON3 | 1860 S GOLDSMITH AVE MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $284 | $27 | $311 | 0.52% |
| MARY CATHERINE WILLIAMS3 Filed as: MARY WILLIAMS | 11059 E BETHANY DR STE 240 AURORA, CO 80014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $253 | $4 | $257 | 0.43% |
| ANNALISA MARIE KURZ3 | 8601 N. BLACK CANYON HWY PHOENIX, AZ 85201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $132 | $111 | $243 | 0.41% |
| LORENZA TORRES3 | 9636 E PASEO SAN BERNARDO DR TUCSON, AZ 85747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $199 | $8 | $207 | 0.35% |
| MARIA GRACIELA PAMANES3 | 7505 EAGLE VISTA DR EL PASO, TX 79911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $16 | $74 | 0.12% |
| VINCENT TAYLOR ECHOLS3 Filed as: VINCENT ECHOLS | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.11% |
| LUISA DE STEFANO3 | 1265 SOUTHWESTERN DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.11% |
| MARIA VERONICA JARQUE3 | 4525 GEORGIA ST SAN DIEGO, CA 92116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $14 | $55 | 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 | $48 | — | $48 | 0.08% |
| EC BENEFITS INC3 | 8038 S 38TH PL PHOENIX, AZ 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.07% |
| SHAWN JEFFERY WARREN3 Filed as: SHAWN JEFFREY WARREN | P.O. BOX 581 SCOTTSDALE, AZ 85252 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $1 | $36 | 0.06% |
| JILL HUGHES3 | 6510 TAMARA DR SALT LAKE CITY, UT 84129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.04% |
| MERKI BENEFITS ADMINISTRATION LLC3 Filed as: MERKI BENEFITS ADMINISTRATION, LLC | 326 VILLA CANTO EL PASO, TX 79920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $11 | $20 | 0.03% |
| DENISE A MAXWELL3 | 3501 W TORANA DR MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $9 | $19 | 0.03% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS, INC. | 509 SOUTH 4TH AVENUE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $7 | $14 | 0.02% |
| VANESSA CARRASCO3 | 1282 ZELLIGE ST EL PASO, TX 79928 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.02% |
| LOIS FLEENER3 | 3196 IVORY DRIVE IDAHO FALLS, ID 83401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $3 | $12 | 0.02% |
| DANIEL ROJAS3 | 6680 CABANA DEL SOL EL PASO, TX 79911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| PAM ANDERSON & ASSOCIATES INC3 | 130 W 8600 S MIDVALE, UT 84047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| EDWARD JOSEPH CORBETT3 Filed as: EDWARD JOSEPH CORBET | 6185 S. PARIS STREET GREENWOOD VILLAGE, CO 80111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD. PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| RITA RIBAS3 | 3624 MIMBRES LANE SANTA FE, NM 87507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| NOAH OROPEZA3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $3 | $5 | 0.01% |
| JULIA MOORE3 | 9208 C ANDERSON DR. NW ALBUQUERQUE, NM 87114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| JAMES D THRESHER3 | 1316 E NIGHTINGALE LANE GILBERT, AZ 85298 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $2 | $4 | 0.01% |
| G ZUBIA ENTERPRISES INC3 Filed as: G ZUBIA ENTERPRISE INC | 2417 MONTANA AVE EL PASO, TX 79903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| JEFFREY GRAY3 Filed as: JEFFREY D. GRAY | 247 SW 13TH STREET ONTARIO, OR 97914 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| STEVE G MONTOYA3 | 23 COUNTY 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% |
| DAVID MCLEOD3 | 409 NM HWY 528 NE RIO RANCHO, NM 87124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 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 | — | $5K | 9.87% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $984 | — | $984 | 11.16% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $558 | $239 | $797 | 14.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 CLAIMS PROCESSOR | Participant communication; Contract Administrator; Float revenue; Other services; Claims processing; Direct payment from the plan; Named fiduciary; Non-monetary compensation Service code 12 | — | $45K |
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 | 240 | 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) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 112 | $214K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 90 | $49K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 116 | $9K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $6K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 70 | $60K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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.