| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 | 2525 E. ARIZONA BILTMORE CIRCLE SUITE D144 PHOENIX, AZ 85016 | BLUE CROSS BLUE SHIELD OF ARIZONA | $32K | — | $32K | 5.45% |
| STEPHANIE WALDROP3 | EMPLOYEE BENEFITS INTERNATIONAL AZ 2525 E. ARIZ BILTMORE CIR, STE D144 PHOENIX, AZ 85016 | DELTA DENTAL OF ARIZONA | $4K | — | $4K | 8.00% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 | 2525 E. ARIZONA BILTMORE CIRCLE SUITE D144 PHOENIX, AZ 85016 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 13.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES, INC. | 3800 N. CENTRAL AVENUE 9TH FLOOR PHOENIX, AZ 85012 | STANDARD INSURANCE COMPANY | $139 | — | $139 | 0.48% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 | 2525 E. ARIZONA BILTMORE CIRCLE SUITE D144 PHOENIX, AZ 85016 | VISION SERVICE PLAN | $576 | — | $576 | 8.83% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES, INC. | 3800 N. CENTRAL AVE. 9TH FLOOR PHOENIX, AZ 850121979 | VISION SERVICE PLAN | $326 | — | $326 | 5.00% |
| EMPLOYEE BENEFITS INTERNATIONAL AZ3 | 2525 E. BILTMNORE CIRCLE SUITE D144 PHOENIX, AZ 85016 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 67.15% |
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 | 116 | 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) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 102 | $590K |
| Dental | DELTA DENTAL OF ARIZONA | 109 | $55K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 102 | $597K |
| Life insurance | STANDARD INSURANCE COMPANY | 116 | $29K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 116 | $32K |
| Long-term disability | STANDARD INSURANCE COMPANY | 116 | $29K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 102 | $590K |
| Other(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 116 | $623K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 116 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.