| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BENEFITS GROUP, LLC | 5080 NORTH 40TH STREET, SUITE 375 PHOENIX, AZ 85018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $58K | $0 | $58K | 6.66% |
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BENEFITS GROUP | 5080 NORTH 40TH STREET, SUITE 375 PHOENIX, AZ 85018 | DELTA DENTAL OF ARIZONA | $17K | $0 | $17K | 5.00% |
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BENEFITS GROUP, LLC | 5080 NORTH 40TH STREET, SUITE 375 PHOENIX, AZ 85018 | EMPLOYERS DENTAL SERVICES | $10K | $0 | $10K | 7.85% |
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BENEFITS GROUP | 5080 NORTH 40TH STREET, SUITE 375 PHOENIX, AZ 85018 | COMPANION LIFE INSURANCE COMPANY | $725 | $0 | $725 | 12.25% |
| DAVISON BENEFITS GROUP LLC3 Filed as: DAVISON BENEFITS GROUP | 5080 NORTH 40TH STREET, SUITE 375 PHOENIX, AZ 85018 | DENTAL ADMINISTRATORS HEALTH PLAN, INC. | $413 | $0 | $413 | 7.57% |
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 | 1,353 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(4 contracts, 4 carriers) | DELTA DENTAL OF ARIZONA | 1,121 | $485K |
| Vision | VISION SERVICE PLAN | 45 | $3K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,841 | $867K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,841 | $867K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,841 | $867K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,841 | $904K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,841 | — |
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.