| 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 | $21K | — | $21K | 11.60% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | 700 W 47TH ST KANSAS CITY, MO 64112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 6.37% |
| JB & H LLC3 | 8707 E SAGUARDO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $40 | $1K | 2.46% |
| BST COMPANIES INC3 Filed as: BST COMPANIES INC. | 319 N CAMERON VIEW PLACE TUCSON, AZ 85745 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $958 | $18 | $976 | 2.11% |
| MARQUEZ BENEFIT GROUP LLC3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | $112 | $264 | 0.57% |
| ANNALISA MARIE KURZ3 | 8601 N. BLACK CANYON HWY PHOENIX, AZ 85201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | $77 | $179 | 0.39% |
| VINCENT TAYLOR ECHOLS3 Filed as: VINCENT ECHOLS | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | — | $60 | 0.13% |
| LUISA DE STEFANO3 | 1265 SOUTHWESTERN DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.11% |
| PAMELA J WALKER3 Filed as: PAMELA J. WALKER | 7457 PRAIRIE ROAD NE ALBUQUERQUE, NM 87109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.11% |
| LORENZA TORRES3 | 9636 E PASEO SAN BERNARDO DR TUCSON, AZ 85747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.10% |
| R AND T FIGUEROA LLC3 Filed as: R & T FIGUEROA LLC | 7569 S CARLISLE AVE TUCSON, AZ 85746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.08% |
| KIMBERLY PETERSON3 | 1860 S GOLDSMITH AVE MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.07% |
| EC BENEFITS INC3 | 8038 S 38TH PL PHOENIX, AZ 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.06% |
| MARIA GRACIELA PAMANES3 | 7505 EAGLE VISTA DR EL PASO, TX 79911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.04% |
| MERKI BENEFITS ADMINISTRATION LLC3 Filed as: MERKI BENEFITS ADMINISTRATION, LLC | 326 VILLA CANTO EL PASO, TX 79920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $10 | $17 | 0.04% |
| VANESSA CARRASCO3 | 1282 ZELLIGE ST EL PASO, TX 79928 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| 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% |
| SHAWN JEFFERY WARREN3 Filed as: SHAWN JEFFREY WARREN | 6950 W. ROWEL PEORIA, AZ 85383 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.02% |
| JILL HUGHES3 | 6510 TAMARA DR SALT LAKE CITY, UT 84129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| JOSEPH QUINTANA3 | 4005 E OSBORN RD. PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| RITA RIBAS3 | 3624 MIMBRES LANE SANTA FE, NM 87507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| DENISE A MAXWELL3 | 3501 W TORANA DR MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $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% |
| LOIS FLEENER3 | 3196 IVORY DRIVE IDAHO FALLS, ID 83401 | 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% |
| G SCOTT COOKE3 Filed as: SCOTT ALLEN BEER | 316 CROCKER STREET, UNIT A TEMPLETON, CA 93465 | 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 | $4K | — | $4K | 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 | $686 | — | $686 | 10.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $483 | $251 | $734 | 15.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 CLAIMS PROCESSOR | Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Float revenue; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $18K |
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 | 244 | 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) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 100 | $183K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 90 | $44K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 98 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 244 | $5K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 63 | $46K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 244 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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.