| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BENEFIT COMMERCE GROUP LLC | 14300 NORTH NORTHSIGHT BLVD #221 SCOTTSDALE, AZ 852603677 | BLUE CROSS BLUE SHIELD OF ARIZONA | $125K | — | $125K | 25.61% |
| CSA GENERAL INSURANCE AGENCY Filed as: CSA GENERAL INSURANCE AGENCY INC. | 2480 WEST LAS PALMARITAS DR PHOENIX, AZ 85021 | COMPANION LIFE INSURANCE COMPANY | $17K | $5 | $17K | 20.01% |
| CSA GENERAL INSURANCE AGENCY Filed as: CSA GENERAL INSURANCE AGENCY INC. | 2480 WEST LAS PALMARITAS DR PHOENIX, AZ 85021 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $10K | $0 | $10K | 14.69% |
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: BENEFIT COMMERCE GROUP LLC | 14300 NORTH NORTHSIGHT BLVD #221 SCOTTSDALE, AZ 852603677 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $140 | $10K | — |
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 | 714 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 715 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 636 | $490K |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 636 | $490K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 1,243 | $561K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $0 |
| Short-term disability | COMPANION LIFE INSURANCE COMPANY | 215 | $85K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 636 | $490K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 636 | $490K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,243 | — |
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.