| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | BLUE CROSS BLUE SHIELD OF ARIZONA | $18K | $0 | $18K | 6.22% |
| AMWINS3 Filed as: AMWINS CONNECT INS. SERVICES, LLC | 2677 NORTH MAIN STREET, SUITE 800 SANTA ANA, CA 92705 | BLUE CROSS BLUE SHIELD OF ARIZONA | $2K | $0 | $2K | 0.57% |
| MARSH & MCLENNAN AGENCY LLC3 | 7202 EAST ROSEWOOD STREET SUITE 200 TUCSON, AZ 85710 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 20.15% |
| MARSH & MCLENNAN AGENCY LLC5 Filed as: MARSH & MCLENNAN AGENCY, LLC | 7202 EAST ROSEWOOD STREET SUITE 200 TUCSON, AZ 85710 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 3.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC, INC. | 3800 NORTH CENTRAL AVENUE 9TH FLOOR PHOENIX, AZ 85012 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $497 | $497 | 1.64% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 7202 EAST ROSEWOOD STREET SUITE 200 TUCSON, AZ 85710 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.17% |
| PERFORMANCE INSURANCE BENEFITS3 Filed as: PERFORMANCE INSURANCE BENEFITS, INC | 20827 NORTH CAVE CREEK ROAD PHOENIX, AZ 85024 | TRANSAMERICA LIFE INSURANCE COMPANY | $311 | $0 | $311 | 2.69% |
| ASSUREDPARTNERS3 | 4544 EAST CAMP LOWELL DRIVE TUCSON, AZ 85712 | TRANSAMERICA LIFE INSURANCE COMPANY | $233 | $0 | $233 | 2.01% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 EAST DOUBLETREE RANCH ROAD SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $114 | — | $114 | 0.99% |
| ASSUREDPARTNERS3 | 14805 NORTH 73RD STREET SCOTTSDALE, AZ 85260 | TRANSAMERICA LIFE INSURANCE COMPANY | $33 | $0 | $33 | 0.29% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 4703 EAST CAMP LOWELL, SUITE 101 TUCSON, AZ 85712 | AMERITAS LIFE INSURANCE CORP. | $555 | $0 | $555 | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC., INC. | 3800 NORTH CENTRAL AVENUE 9TH FLOOR PHOENIX, AZ 85012 | AMERITAS LIFE INSURANCE CORP. | $251 | $0 | $251 | 4.52% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 412703 BOSTON, MA 02241 | HEALTHIEST YOU | $169 | — | $169 | 15.02% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 65 | $299K |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 65 | $288K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 90 | $6K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $30K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $30K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $30K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 65 | $288K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.