| 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 | $3K | $7K | 3.53% |
| 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 | $26K | $7K | $33K | 18.89% |
| JENNIFER O'ROURKE3 | 7425 N. MONA LISA RD. APT 55 TUCSON, AZ 85741 | AFLAC | $11K | $856 | $12K | 12.91% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | AFLAC | $4K | — | $4K | 4.18% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85658 | AFLAC | $3K | $107 | $3K | 3.03% |
| KIMBERLY RODRIGUEZ3 | 37057 S GAMBEL QUAIL DR MARANA, AZ 85658 | AFLAC | $2K | $107 | $2K | 1.92% |
| ZAKERY HARLOW3 | 2960 N ACADEMY BLVD. SUITE 101 COLORADAO SPRINGS, CO 80917 | AFLAC | $714 | $71 | $785 | 0.85% |
| KEVIN DALE HARLOW3 Filed as: KEVIN HARLOW | 2960 N. ACADEMY BLVD. COLORADA SPRINGS, CO 80917 | AFLAC | $751 | — | $751 | 0.82% |
| JANELL FRANK3 | 9110 RAILROAD DR. STE 230 MANASSAS PARK, VA 20111 | AFLAC | $659 | $64 | $723 | 0.79% |
| DAVID R LATTIMER3 Filed as: DAVID LATTIMER | 3029 N SONORAN HILLS MESA, AZ 85207 | AFLAC | $518 | — | $518 | 0.56% |
| H OLIPHANT3 | 3580 WEST INA RD SUITE 150 TUCSON, AZ 85741 | AFLAC | $475 | — | $475 | 0.52% |
| CATHERINE DAVIS3 | 9160 E. LOMA LINDA PLACE TUCSON, AZ 85749 | AFLAC | $195 | $30 | $225 | 0.24% |
| SANDA SARFF3 | 7090 N ORACLE RD. PMB 152 TUCSON, AZ 85704 | AFLAC | $113 | — | $113 | 0.12% |
| SCOTT WEBB3 | 12366 W MILTON DR PEORIA, AZ 85383 | AFLAC | $65 | — | $65 | 0.07% |
| MARK HILL3 | PO BOX 85715 TUCSON, AZ 85754 | AFLAC | $50 | — | $50 | 0.05% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $49 | — | $49 | 0.05% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 360 W HUBBARD ST APT 1105 CHICAGO, IL 60654 | AFLAC | $43 | — | $43 | 0.05% |
| JERRY HOKE3 | 517 E 3270 N LEHI, UT 84043 | AFLAC | $41 | — | $41 | 0.04% |
| ERIC PEDERSON3 | 2615 N 4TH STE STE 1 FLAGSTAFF, AZ 86004 | AFLAC | $40 | — | $40 | 0.04% |
| CHEYANNA SARFF3 | 3737 W CROMWELL DR. TUCSON, AZ 85741 | AFLAC | $37 | — | $37 | 0.04% |
| RACHEL DAY3 | 5533 E 24TH ST TUCSON, AZ 85711 | AFLAC | $27 | — | $27 | 0.03% |
| JULIE KICKER3 | PO BOX 11825 CASA GRANDE, AZ 85130 | AFLAC | $24 | — | $24 | 0.03% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LANE PHOENIX, AZ 85042 | AFLAC | $11 | — | $11 | 0.01% |
| HEATHER HAWK3 | 8252 N NORTHERN AVE APT 4104 TUCSON, AZ 85704 | AFLAC | $11 | — | $11 | 0.01% |
| BRENDA S O BERRY3 Filed as: BRENDA O BERRY | PO BOX 686 THATCHER, AZ 85552 | AFLAC | $11 | — | $11 | 0.01% |
| JACOB C ECHOLS3 Filed as: JACOB ECHOLS | 3850 E BASELINE RD STE 116 MESA, AZ 85206 | AFLAC | $9 | — | $9 | 0.01% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $7 | — | $7 | 0.01% |
| NATALIE MALHAM3 | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $7 | — | $7 | 0.01% |
| STELLA MAQUERA3 | 4002 E ELMWOOD ST TUCSON, AZ 85711 | AFLAC | $7 | — | $7 | 0.01% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 3420 E SHEA BLVD. SUITE 168 PHOENIX, AZ 85028 | AFLAC | $7 | — | $7 | 0.01% |
| JEFFREY S GIBSON3 Filed as: JEFFREY GIBSON | 3009 HUNTON COTTAGE LANE GLEN ALLEN, VA 23059 | AFLAC | $6 | — | $6 | 0.01% |
| PREFERRED MARKETING CORP3 | 1194 E LAKEVIEW DR. SAN TAN VALLEY, AZ 85143 | AFLAC | $5 | — | $5 | 0.01% |
| SHARON MCKELVEY3 | 197 N NOTTINGHAM LANE LOT 3 PAYSON, AZ 85541 | AFLAC | $5 | — | $5 | 0.01% |
| SHAWN HOLTORF3 | 5522 W NORTHWOOD DR GLENDALE, AZ 85310 | AFLAC | $4 | — | $4 | 0.00% |
| MICHAEL G RYAN3 Filed as: MICHAEL RYAN | 836 HOOSIER PASS PRESCOTT, AZ 85301 | AFLAC | $3 | — | $3 | 0.00% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 4910 CORPORATE DR NW STE G HUNTSVILLE, AL 35805 | AFLAC | $2 | — | $2 | 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 | $3K | $12K | 14.16% |
| 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 | $12K | $3K | $15K | 18.80% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W. 47TH ST. STE 1100 KANSAS CITY, MO 641121922 | VISION SERVICE PLAN | $961 | — | $961 | 1.80% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | P.O. BOX 632886 CINCINNATI, OH 452632886 | EMPLOYERS DENTAL SERVICES | $2K | — | $2K | 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 | $898 | $3K | 14.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $192K |
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 | 533 | 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) | 533 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 721 | $230K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 721 | $253K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 533 | $99K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $265K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 533 | $81K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 533 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 721 | — |
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.