| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS INTL AZ INC Filed as: EMPLOYEE BENEFITS INT AZ INC | 7901 N 16TH STREET SUITE 200 PHOENIX, AZ 85020 | BLUE CROSS BLUE SHIELD OF ARIZONA | $57K | $0 | $57K | 14.42% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ | 7901 N 16TH ST STE 200 PHOENIX, AZ 85020 | HARTFORD LIFE AND ACCIDENT | $35K | $0 | $35K | 11.49% |
| EMPLOYEE BENEFITS INTERNATIONAL Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 7901 N 16TH ST STE 200 PHOENIX, AZ 85020 | DELTA DENTAL OF ARIZONA | $11K | $0 | $11K | 8.00% |
| EMPLOYEE BENEFITS INTERNATIONAL5 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 2525 EAST ARIZONA BILTMORE CIRCLE D144 PHOENIX, AZ 85016 | AVESIS INSURANCE INCORPORATED | $2K | $0 | $2K | 10.00% |
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 | 285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 360 | $397K |
| Dental | DELTA DENTAL OF ARIZONA | 406 | $136K |
| Vision | AVESIS INSURANCE INCORPORATED | 352 | $25K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 285 | $303K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 285 | $303K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 285 | $303K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 360 | $397K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 360 | $397K |
| Other | HARTFORD LIFE AND ACCIDENT | 285 | $303K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 406 | — |
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.