| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS INTL AZ INC3 Filed as: EMPLOYEE BENEFITS INT. ARIZONA, INC | 7901 NORTH 16TH STREET, SUITE 200 PHOENIX, AZ 85020 | BLUE CROSS BLUE SHIELD OF ARIZONA | $64K | $0 | $64K | 14.02% |
| EMPLOYEE BENEFITS INTL AZ INC3 Filed as: EMPLOYEE BENEFITS INT. ARIZONA, INC | 7901 NORTH 16TH STREET, SUITE 200 PHOENIX, AZ 85020 | HARTFORD LIFE AND ACCIDENT | $36K | $17K | $53K | 16.68% |
| EMPLOYEE BENEFITS INTL AZ INC3 Filed as: EMPLOYEE BENEFITS INT. ARIZONA | 7901 NORTH 16TH STREET, SUITE 200 PHOENIX, AZ 85020 | DELTA DENTAL OF ARIZONA | $14K | $0 | $14K | 8.01% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 2525 EAST ARIZONA BILTMORE CIRCLE SUITE D144 PHOENIX, AZ 85016 | AVESIS INSURANCE INCORPORATED | $3K | $0 | $3K | 10.01% |
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 | 388 | 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) | 388 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 255 | $457K |
| Dental | DELTA DENTAL OF ARIZONA | 259 | $175K |
| Vision | AVESIS INSURANCE INCORPORATED | 472 | $33K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 372 | $321K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 372 | $321K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 372 | $321K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 255 | $457K |
| Other | HARTFORD LIFE AND ACCIDENT | 372 | $321K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 472 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.