| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W. 47TH STREET, SUITE 1100 KANSAS CITY, MO 641121922 | AMERITAS LIFE INSURANCE CORP. | $4K | $1K | $5K | 3.07% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $22K | $5K | $27K | 18.10% |
| JENNIFER O'ROURKE3 | 7425 N. MONA LISA RD. APT 55 TUCSON, AZ 85741 | AFLAC | $9K | $970 | $10K | 12.63% |
| ZAKERY HARLOW3 | 3204 N ACADEMY BLVD. SUITE 130 COLORADAO SPRINGS, CO 80917 | AFLAC | $2K | $205 | $2K | 2.61% |
| JANELL FRANK3 | 7571 N RAE AVE TUCSON, AZ 85741 | AFLAC | $2K | $79 | $2K | 2.52% |
| KEVIN DALE HARLOW3 Filed as: KEVIN HARLOW | 3204 N. ACADEMY BLVD. SUITE 130 COLORADA SPRINGS, CO 80917 | AFLAC | $1K | $126 | $1K | 1.69% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | AFLAC | $1K | — | $1K | 1.55% |
| KIMBERLY RODRIGUEZ3 | 37057 S. GAMBEL QUAIL DR. MARANA, AZ 85658 | AFLAC | $651 | — | $651 | 0.80% |
| HEATHER HAWK3 | 8215 N ORACLE RD APT 248 TUCSON, AZ 85704 | AFLAC | $582 | $53 | $635 | 0.78% |
| H OLIPHANT3 | 3580 WEST INA RD SUITE 150 TUCSON, AZ 85741 | AFLAC | $509 | — | $509 | 0.63% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $421 | — | $421 | 0.52% |
| CATHERINE DAVIS3 | 9160 E. LOMA LINDA PLACE TUCSON, AZ 85749 | AFLAC | $203 | — | $203 | 0.25% |
| SANDA SARFF3 | 7090 N ORACLE RD. 178 PMB 152 TUCSON, AZ 85704 | AFLAC | $123 | — | $123 | 0.15% |
| SCOTT WEBB3 | 1155 W PINNACLE PEAK RD SUITE 205 PHOENIX, AZ 85027 | AFLAC | $78 | — | $78 | 0.10% |
| MARK HILL3 | PO BOX 85715 TUCSON, AZ 85754 | AFLAC | $63 | — | $63 | 0.08% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $58 | — | $58 | 0.07% |
| ERIC PEDERSON3 | 2615 N 4TH STREET SUITE 1 FLAGSTAFF, AZ 86004 | AFLAC | $55 | — | $55 | 0.07% |
| JERRY HOKE3 | 517 E 3270 N LEHI, UT 84043 | AFLAC | $49 | — | $49 | 0.06% |
| CHEYANNA SARFF3 | 3737 W CROMWELL DR. TUCSON, AZ 85741 | AFLAC | $44 | — | $44 | 0.05% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 360 W HUBBARD ST APT 1105 CHICAGO, IL 60654 | AFLAC | $43 | — | $43 | 0.05% |
| RACHEL DAY3 | 5533 E 24TH ST TUCSON, AZ 85711 | AFLAC | $36 | — | $36 | 0.04% |
| JULIE KICKER3 | 719 E COTTONWOOD LANE CASA GRANDE, AZ 85122 | AFLAC | $28 | — | $28 | 0.03% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LANE PHOENIX, AZ 85042 | AFLAC | $15 | — | $15 | 0.02% |
| BRENDA S O BERRY3 Filed as: BRENDA O BERRY | P.O. BOX 686 THATCHER, AZ 85552 | AFLAC | $13 | — | $13 | 0.02% |
| JACOB C ECHOLS3 Filed as: JACOB ECHOLS | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $11 | — | $11 | 0.01% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $9 | — | $9 | 0.01% |
| NATALIE MALHAM3 | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $9 | — | $9 | 0.01% |
| STELLA MAQUERA3 | 4002 E ELMWOOD ST TUCSON, AZ 85711 | AFLAC | $8 | — | $8 | 0.01% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 3420 E SHEA BLVD. SUITE 168 PHOENIX, AZ 85028 | AFLAC | $8 | — | $8 | 0.01% |
| JEFFREY S GIBSON3 Filed as: JEFFREY GIBSON | 4805 LAKE BROOK DR SUITE 220 GLEN ALLEN, VA 23060 | AFLAC | $7 | — | $7 | 0.01% |
| PREFERRED MARKETING CORP3 | 1194 E LAKEVIEW DR. SAN TAN VALLEY, AZ 85143 | AFLAC | $6 | — | $6 | 0.01% |
| SHARON MCKELVEY3 | 197 N NOTTINGHAM LANE LOT 3 PAYSON, AZ 85541 | AFLAC | $6 | — | $6 | 0.01% |
| SHAWN HOLTORF3 | 5522 W NORTHWOOD DR GLENDALE, AZ 85310 | AFLAC | $5 | — | $5 | 0.01% |
| MICHAEL G RYAN3 Filed as: MICHAEL RYAN | 836 HOOSIER PASS PRESCOTT, AZ 85301 | AFLAC | $4 | — | $4 | 0.00% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 29622 N 21ST DR PHOENIX, AZ 85085 | AFLAC | $3 | — | $3 | 0.00% |
| TIMOTHY MARTIN3 | 20516 N 80TH LANE PEORIA, AZ 85382 | AFLAC | $2 | — | $2 | 0.00% |
| JOHN BURLEY3 | 3060 W CALLE LUCINDA TUCSON, AZ 85741 | AFLAC | $2 | — | $2 | 0.00% |
| JULIA ANN COAST3 Filed as: JULIA COAST | 1409 E MALIBU DR TEMPE, AZ 85282 | AFLAC | $1 | — | $1 | 0.00% |
| LINDA J DOSS3 Filed as: LINDA DOSS | 6556 S VAN BUREN AVE TUCSON, AZ 85756 | AFLAC | $1 | — | $1 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $10K | 13.22% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $2K | $12K | 18.10% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W. 47TH ST. STE 1100 KANSAS CITY, MO 641121922 | VISION SERVICE PLAN | $826 | — | $826 | 1.81% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | P.O. BOX 632886 CINCINNATI, OH 452632886 | EMPLOYERS DENTAL SERVICES | $3K | — | $3K | 7.97% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $656 | $3K | 13.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $170K |
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 | 605 | 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) | 605 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 605 | $198K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 605 | $212K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 493 | $86K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $231K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 492 | $75K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 493 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 605 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.