| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARQUEZ BENEFIT GROUP LLC3 | 12057 WEST ROWEL ROAD PEORIA, AZ 85383 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $13K | $24K | 24.83% |
| MJ INSURANCE3 Filed as: EDUARDO BARAJAS AND VARIOUS AGENTS | 1703 WEST NATAL AVENUE MESA, AZ 85202 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $271 | $6K | 5.89% |
| JB & H LLC3 Filed as: JB AND H LLC | 8707 EAST SAGUARDO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $399 | $2K | 1.77% |
| KELLIE GREENE VALDEZ3 | 8611 NORTH BLACK CANYON HIGHWAY PHOENIX, AZ 85021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $123 | $1K | 1.32% |
| JEFFRY MICHAEL DORN3 Filed as: JEFFRY MICHAEL DOM | 20235 NORTH CAVE CREEK ROAD PHOENIX, AZ 85024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $116 | $1K | 1.25% |
| CHANDA MANSKE3 | 12145 WEST JESSIE COURT SUN CITY, AZ 85373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $817 | $294 | $1K | 1.14% |
| SHAWN JEFFERY WARREN3 | PO BOX 581 SCOTTSDALE, AZ 85252 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $636 | $459 | $1K | 1.12% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 120 | $98K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 120 | $98K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 120 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.