| 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 | $10K | $0 | $10K | 4.55% |
| DULEY BOLWAR & ASSOCIATES INC3 | 14805 N 73RD ST SCOTTSDALE, AZ 85260 | BLUE CROSS BLUE SHIELD OF ARIZONA | $7K | $0 | $7K | 2.92% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF ARIZONA LLC | 4544 E CAMP LOWELL DR SUITE 110 TUSCON, AZ 85712 | BLUE CROSS BLUE SHIELD OF ARIZONA | $2K | $0 | $2K | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1115 STOCKTON HILL RD STE 101 KINGMAN, AZ 86401 | AMERITAS LIFE INSURANCE CORP | $2K | $0 | $2K | 2.58% |
| DULEY BOLWAR & ASSOCIATES INC3 | 14805 N 73RD ST SCOTTSDALE, AZ 85260 | AMERITAS LIFE INSURANCE CORP | $440 | $189 | $629 | 0.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 21ST FLOOR ROLLING MEADOWS, IL 60008 | AMERITAS LIFE INSURANCE CORP | $0 | $206 | $206 | 0.28% |
| DULEY BOLWAR & ASSOCIATES INC3 Filed as: DULEY BOLWAR & ASSOC INC | 1480S N. 73RD ST SCOTTSDALE, AZ 85260 | GUARDIAN LIFE INSURANCE | $5K | $265 | $5K | 9.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $1K | $4K | 12.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1115 STOCKTON HILL RD SUITE 101 KINGMAN, AZ 86401 | GUARDIAN LIFE INSURANCE | $1K | $0 | $1K | 5.66% |
| 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 | $80K |
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 | 231 | 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) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 128 | $224K |
| Dental | AMERITAS LIFE INSURANCE CORP | 231 | $74K |
| Vision | AMERITAS LIFE INSURANCE CORP | 231 | $74K |
| Life insurance(3 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE | 127 | $110K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 128 | $224K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ARIZONA | 128 | $224K |
| Other(4 contracts, 3 carriers) | AMERITAS LIFE INSURANCE CORP | 231 | $184K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.