| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVS INC | 1111 SUPERIOR AVE EAST SUITE 1601 CLEVELAND, OH 44114 | BLUE CROSS BLUE SHIELD OF ARIZONA | $24K | — | $24K | 8.99% |
| ERIN P. COLLINS & ASSOCIATES, INC.3 Filed as: ERIN COLLINS & ASSOCIATES | 1115 STOCKTON HILL RD STE 101 KINGMAN, AZ 86401 | BLUE CROSS BLUE SHIELD OF ARIZONA | $2K | — | $2K | 0.75% |
| ERIN P. COLLINS & ASSOCIATES, INC.3 | 1115 STOCKTON HILL RD STE 101 KINGMAN, AZ 86401 | AMERITAS LIFE INSURANCE CORP | $2K | $266 | $2K | 2.43% |
| GALLAGHER BENEFIT SERVICES, INC.6 Filed as: GALLAGHER BENEFIT SERVICES INC | 1115 STOCKTON HILL RD STE 101 KINGMAN, AZ 86401 | AMERITAS LIFE INSURANCE CORP | $1K | — | $1K | 1.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | AMERITAS LIFE INSURANCE CORP | — | $385 | $385 | 0.40% |
| ERIN P. COLLINS & ASSOCIATES, INC.3 Filed as: ERIN COLLINS & ASSOC INC | 1115 STOCKTON HILL RD SUITE 101 KINGMAN, AZ 86401 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1115 STOCKTON HILL RD STE 101 KINGMAN, AZ 86401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $375 | — | $375 | 4.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.30% |
| M&O AGENCIES DBA THE MAHONEY GROUP3 | 1835 S. EXTENSION RD MESA, AZ 85210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1115 STOCKTON HILL RD STE 101 KINGMAN, AZ 86401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $293 | — | $293 | 9.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3 | — | $3 | 0.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 N/A | Contract Administrator Service code 13 | P.O. BOX 13466 PHOENIX, AZ 850023466 | $96K |
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 | 235 | 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) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 146 | $262K |
| Dental | AMERITAS LIFE INSURANCE CORP | 235 | $95K |
| Vision | AMERITAS LIFE INSURANCE CORP | 235 | $95K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 114 | $23K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 146 | $262K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 146 | $262K |
| Other(4 contracts, 4 carriers) | AMERITAS LIFE INSURANCE CORP | 235 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.