| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STUCKEY INSURANCE & ASSOCIATES3 | 5343 N. 16TH STREET SUITE 110 PHOENIX, AZ 85016 | BLUE CROSS BLUE SHIELD OF ARIZONA | $16K | — | $16K | 2.56% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE RD. SUITE 505 INDEPENDENCE, OH 44131 | BLUE CROSS BLUE SHIELD OF ARIZONA | $10K | — | $10K | 1.65% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 | 2525 E. ARIZONA BILTMORE CIRCLE SUITE D144 PHOENIX, AZ 85016 | BLUE CROSS BLUE SHIELD OF ARIZONA | $5K | — | $5K | 0.80% |
| MARY E LODWICK3 Filed as: MARY LODWICK | STUCKEY INSURANCE AND ASSOCIATES 5343 N. 16TH STREET, SUITE 110 PHOENIX, AZ 85016 | DELTA DENTAL OF ARIZONA | $2K | — | $2K | 3.56% |
| STEPHANIE WALDROP3 | EMPLOYEE BENEFITS INTERNATIONAL AZ 2525 E. ARIZ BILTMORE CIR, STE D144 PHOENIX, AZ 85016 | DELTA DENTAL OF ARIZONA | $1K | — | $1K | 2.49% |
| STEPHANIE WALDROP3 | EMPLOYEE BENEFITS INTERNATIONAL INC 4700 ROCKSIDE RD., SUITE 505 INDEPENDENCE, OH 44131 | DELTA DENTAL OF ARIZONA | $1K | — | $1K | 1.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES, INC. | 3800 N. CENTRAL AVENUE 9TH FLOOR PHOENIX, AZ 85012 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 11.23% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 4700 ROCKSIDE RD. SUITE 505 INDEPENDENCE, OH 44131 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 5.20% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 | 2525 E. ARIZONA BILTMORE CIRCLE SUITE D144 PHOENIX, AZ 85016 | STANDARD INSURANCE COMPANY | $279 | — | $279 | 1.03% |
| STUCKEY INSURANCE & ASSOCIATES3 | 5343 N. 16TH STREET SUITE 110 PHOENIX, AZ 85016 | VISION SERVICE PLAN | $358 | — | $358 | 5.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES, INC. | 3800 N. CENTRAL AVE. 9TH FLOOR PHOENIX, AZ 850121979 | VISION SERVICE PLAN | $355 | — | $355 | 5.00% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 | 2525 E. ARIZONA BILTMORE CIRCLE SUITE D144 PHOENIX, AZ 85016 | VISION SERVICE PLAN | $132 | — | $132 | 1.86% |
| EMPLOYEE BENEFITS INTERNATIONAL3 Filed as: EMPLOYEE BENEFITS INTERNATIONAL INC | 2525 E. ARIZONA BILTMORE CIRCLE SUITE D144 PHOENIX, AZ 85016 | VISION SERVICE PLAN | $115 | — | $115 | 1.62% |
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 | 105 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 99 | $618K |
| Dental | DELTA DENTAL OF ARIZONA | 98 | $58K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 99 | $625K |
| Life insurance | STANDARD INSURANCE COMPANY | 106 | $27K |
| Short-term disability | STANDARD INSURANCE COMPANY | 106 | $27K |
| Long-term disability | STANDARD INSURANCE COMPANY | 106 | $27K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 99 | $618K |
| Other(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 106 | $645K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.