| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BENEFITS GROUP, LLC | 6900 E INDIAN SCHOOL RD SUITE 100 SCOTTSDALE, AZ 85251 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $53K | $0 | $53K | 6.68% |
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BENEFITS GROUP, LLC | 6900 E INDIAN SCHOOL RD, SUITE 100 SCOTTSDALE, AZ 85251 | BLUE CROSS BLUE SHIELD OF ARIZONA | $180K | $0 | $180K | 55.40% |
| DAVISON BENEFITS GROUP LLC3 | 6900 E INDIAN SCHOOL RD STE 100 SCOTTSDALE, AZ 85251 | DELTA DENTAL OF ARIZONA | $14K | $0 | $14K | 5.05% |
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BPNEFITS GROUP LLC | 6900 E INDIAN SCHOOL RD STE 100 SCOTTSDALE, AZ 85251 | EMPLOYERS DENTAL SERVICES | $11K | $0 | $11K | 7.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $873K |
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 | 1,207 | 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) | 1,207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 1,207 | $325K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF ARIZONA | 518 | $423K |
| Vision | BLUE CROSS BLUE SHIELD OF ARIZONA | 1,207 | $325K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,482 | $798K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,482 | $798K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,482 | $798K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 1,207 | $325K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 1,207 | $325K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,482 | $834K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,482 | — |
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.