| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | MUTUAL OF OMAHA INSURANCE COMPANY | $8K | $3K | $11K | 14.16% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE SVS IN | PO BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF ARIZONA | $6K | — | $6K | 10.93% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | MUTUAL OF OMAHA INSURANCE COMPANY | $4K | $2K | $6K | 14.27% |
| JENNIFER O'ROURKE3 Filed as: JENNIFER OROURKE | 7759 N SILVERBELL RD APT #17104 TUCSON, AZ 85743 | AFLAC | $3K | $48 | $3K | 8.60% |
| IVETTE BIRNEY3 | 10028 E MOONSTRUCK WAY TUCSON, AZ 85747 | AFLAC | $1K | $856 | $2K | 6.14% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $2K | $0 | $2K | 4.30% |
| KEVIN DALE HARLOW3 | 6284 N ORACLE RD UNIT 35072 TUCSON, AZ 85740 | AFLAC | $1K | $91 | $1K | 3.51% |
| ZAKERY ALLEN HARLOW3 | 4566 N 1ST ST #140 TUCSON, AZ 85716 | AFLAC | $748 | $91 | $839 | 2.39% |
| SCOTT WEBB3 | 2355 W PINNACLE PEAK RD STE 380 PHOENIX, AZ 85037 | AFLAC | $138 | $91 | $229 | 0.65% |
| MARK K HASLEY3 Filed as: MARK HASLEY | 21925 N 70TH AVE GLENDALE, AZ 85310 | AFLAC | $185 | — | $185 | 0.53% |
| SETH G KNOWLTON3 | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $177 | — | $177 | 0.50% |
| MARTHA A QUIROZ3 | 2581 W VEREDA VERDE TUCSON, AZ 85746 | AFLAC | $91 | $67 | $158 | 0.45% |
| PATTY J NATIONS3 Filed as: PATTY NATIONS | PO BOX 89639 TUCSON, AZ 85752 | AFLAC | $110 | — | $110 | 0.31% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LN PHOENIX, AZ 85042 | AFLAC | $48 | $0 | $48 | 0.14% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $47 | — | $47 | 0.13% |
| CHAD P SCHNEIDER3 | 14430 BENEFIT ST APT 308 SHERMAN OAKS, CA 91423 | AFLAC | $44 | — | $44 | 0.13% |
| ERIC PEDERSON3 | 1600 W UNIVERSITY AVE STE 104 FLAGSTAFF, AZ 86001 | AFLAC | $42 | — | $42 | 0.12% |
| MARK HILL3 | 7673 N SUMMIT PASS PRESCOTT VALLEY, AZ 86315 | AFLAC | $40 | — | $40 | 0.11% |
| LESLIE J BAILEY3 | 4234 N PORTAGE AVE MERIDIAN, IN 83648 | AFLAC | $34 | — | $34 | 0.10% |
| SANDRASARFF3 | 7090 N ORACLE RD 178 PMB 152 TUCSON, AZ 85704 | AFLAC | $14 | — | $14 | 0.04% |
| JESSICA M STOGSDILL3 | 7451 E DESERT AIRE DR TUCSON, AZ 85730 | AFLAC | $13 | — | $13 | 0.04% |
| HELEN HAGARDT3 | 9076 N IRONWOOD MEADOWS DR TUCSON, AZ 85742 | AFLAC | $7 | — | $7 | 0.02% |
| JERRY DUNCAN3 Filed as: JERRY F HOKE | 517 E 3270 N LEHI, UT 84043 | AFLAC | $5 | — | $5 | 0.01% |
| CHEANNA SARFF3 | 10553 E AVALON PARK TUCSON, AZ 85747 | AFLAC | $5 | — | $5 | 0.01% |
| STELLA MAQUERA3 | 4002 E ELMWOOD ST TUCSON, AZ 85711 | AFLAC | $4 | — | $4 | 0.01% |
| ARIZONA BENEFITS PLANS INC3 | 1 E CAMELBACK RD STE 840 PHOENIX, AZ 85012 | AFLAC | $3 | — | $3 | 0.01% |
| ROBERT E LABONTE3 | 1659 W SAN REMO ST GILBERT, AZ 85233 | AFLAC | $1 | — | $1 | 0.00% |
| PREFERRED MARKETING CORP3 Filed as: PREFERRED MARKETING GROUP | 7402 KINGS RIVER CT HUMBLE, TX 77346 | AFLAC | $1 | — | $1 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | MUTUAL OF OMAHA INSURANCE COMPANY | $5K | $1K | $6K | 19.21% |
| CARING COMMUNITIES3 | 5630 ENTERPRISE ST SYKESVILLE, MD 21784 | AIG BENEFIT SOLUTIONS | $16K | — | $16K | 65.98% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 601 16TH STREET, SUITE C-311 GOLDEN, CO 80401 | AIG BENEFIT SOLUTIONS | $8K | — | $8K | 34.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $1K | — | $1K | 5.60% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $636 | $2K | 13.86% |
| AMERIBEN3 Filed as: AMERIBEN IEC GROUP | PO BOX 7186 BOISE, ID 83707 | AMERIBEN IEC GROUP | — | $71K | $71K | — |
| PHARMACUTICAL TECHNOLOGIES INC | 13660 CALIFORNIA ST OMAHA, NE 68154 | PHARMACEUTICAL TECHNOLOGIES, INC. | — | $18K | $18K | — |
| TARGET CORPORATION3 Filed as: TARGET GROUP LLC | 5553 S LAREDO ST CENTENNIAL, CO 80015 | PHARMACEUTICAL TECHNOLOGIES, INC. | $2K | — | $2K | — |
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 | 410 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 410 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERIBEN IEC GROUP | 0 | $0 |
| Dental | DELTA DENTAL OF ARIZONA | 125 | $59K |
| Vision | VISION SERVICE PLAN | 132 | $19K |
| Short-term disability(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 385 | $113K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 67 | $16K |
| Prescription drug | PHARMACEUTICAL TECHNOLOGIES, INC. | 420 | $0 |
| Stop-loss / reinsurancereinsurance | AIG BENEFIT SOLUTIONS | 508 | $24K |
| Other(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 385 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.